Comparison of small incision cataract surgery with conventional extra capsular cataract surgery: an evaluation from resource poor setting in India

Background: Cataract is the chief cause of avoidable blindness in the developing countries of the world including India. These patients can regain normal sight with the help of cataract surgery, which has undergone many advances and Small Incision Cataract Surgery (SICS) has gained wide acceptance world over as the surgical method requires minimal infrastructure. The present study compares it's safety profile for the patients as well as acceptability amongst the doctors performing conventional Extra Capsular Cataract Extraction (ECCE) surgery in peripheral resource poor settings. Methods: All patients having cataract were examined prior to surgery and were randomized in two groups: group I - small incision cataract surgery and group II - conventional extra capsular cataract extraction surgery with posterior capsular intra ocular lens implantation. The various intra and post-operative complications were evaluated. Results: 252 eyes of 252 patients were enrolled with 121 patients in group I and 131 patients in group II and intra-operative and post-operative complications compared. Intra-operatively difficulty in nucleus delivery was higher in group I (12.3%) whereas repeated iris protrusion (12.5%) and posterior capsular rent (8.3%) was higher in group II. Postoperatively, on day 1 striate keratopathy was commoner in group I (20.6%) whereas uveitis was seen more commonly (26.7%) in group II. At 6 weeks, surgically induced astigmatism was higher (61%) in group II as compared to group I (35%). Conclusion: SICS is a safe and acceptable alternative to conventional ECCE in a peripheral teaching setup.