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ME Arriaga, J Lozano; A Comparative Study of Visual Acuity Outcomes: Phacoemulsification vs Extracapsular Cataract Extraction . Invest. Ophthalmol. Vis. Sci. 2002;43(13):360.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose:Phacoemulsification is rapidly replacing conventional extracapsular cataract extraction (ECCE) as the method of choice for cataract surgery in the developing world. The purpose of this study is to compare the visual acuity outcomes between phacoemulsificaction+intraocular lens implantation (IOL) and ECCE+IOL. Methods:A retrospective, comparative and descriptive analysis has been performed on a database of 100 eyes of 85 patients who underwent ECCE + IOL and phacoemulsification +IOL. The variables included were: gender,age, pre and postoperative visual acuity and keratometries. Postoperative visual acuity and keratometries were compared between the two groups in the 4th and 8th week after the surgery. Results:Fifty percent of cases underwent phacoemulsification, and fifty percent underwent ECCE. Visual acuity before surgery of the patients that underwent phacoemulsification was 20/400 or less (66%) and patients that underwent ECCE was Count Fingers (CD) (40%). Seventeen eyes (34%) managed with extracapsular surgery achieved visual acuity of 20/20 to 20/30, 31 eyes (62%) achieved visual acuity of 20/40 to 20/80 and 2 eyes (4%) had a visual outcome of 20/100 at the 4th week of the postoperative period. Thirty nine eyes (78%) managed with phacoemulsification surgery achieved visual acuity of 20/20 to 20/30, 10 eyes (20%) achieved visual acuity of 20/40 to 20/80 and only 1 eye (2%) had a visual outcome of 20/100, in the 4th week of the postoperative period. Compared with eyes underwent phacoemulsification, eyes operated on with extracapsular surgery in the 8th week of the postoperative, 33 eyes (66%) achieved visual acuity of 20/20 to 20/30 and 17 eyes (34%) achieved visual acuity of 20/40 to 20/80, 38 eyes (76%) operated with phacoemulsification had a visual outcome of 20/20 to 20/30 and 12 eyes (24%) of 20/40 to 20/80. The residual astigmatism of 42 eyes (84%) after phacoemulsification ranged from 0 to -1.5 spherical equivalent (SE) and 8 eyes (16%) -1.75 to -3.25 SE. Eighteen eyes (36%) after ECCE was from 0 to -1.5 SE and Thirty two eyes (64%), -1.75 to- 6.5 SE. Conclusion:This study has demonstrated the advantage of phacoemulsification over conventional ECCE as we observed in 78% of cases that achieved visual acuity of 20/20 to 20/30. Both techniques showed similar visual outcomes at 8th week after surgery. Minimal residual astigmatism was observed in 84% of cases treated with phaco, meanwhile in ECCE technique, 36% showed a higher astigmatism This is believed to reduce surgically induced astigmatism and enables stable refraction, visual rehabilitation and daily activities.
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