Abstract
Purpose :
Cataract is considered to be the main reason (75%) for blindness in Ecuador and the principal barrier for the treatment is the cost of the surgery. Phacoemulsification (Phaco) and small incision cataract surgery (SICS) are considered to be the two main techniques but at different costs. The main purpose is to compare Phaco vs SICS by evaluating the best corrected visual acuity in patients at Luis Vernaza Hospital, Guayaquil, Ecuador, 2015.
Methods :
A retrospective cohort study. A total of 683 medical records were evaluated from January to December 2015. Inclusion criterial were patients intervened with Phaco or SICS in the indicated period, with complete surgical record and clinical history. Patients who previously had ocular surgery or any ocular comorbidity that affect vision were excluded. The variables collected: age (years), gender, comorbidities like systemic arteria hypertension (SAH) and diabetes mellitus (DM), best corrected visual acute (BCVA) pre and post-surgery in LogMAR, spherical equivalent refraction (SER) pre and post-surgery in diopters and intra-surgery complication. Descriptive statistical analysis and t test were used when appropriate. The study was approved by research department of the Universidad Espiritu Santo and Hospital Luis Vernaza
Results :
58 patients were included: 27 patients underwent Phaco (47%) and 31 SICS (53%). 34 females (59%) and 24 (41%) males, with mean age of 68.1 ± 9.9 years. 27 patients (47%) had SAH and 18 (31%) had DM. The BCVA pre-surgery was 1.02 ± 1 in Phaco group and 0.40 ± 0.30 in SICS group, p = 0.004. The BCVA post-surgery was 0.19 ± 0.29 in Phaco group and 0.13 ± 0.23 in SICS group, p = 0.41. The SER pre-surgery was 0.91 ± 1.97 diopters in Phaco group and 0.69 ± 2.39 diopters in SICS group, p= 0.7. The SER post-surgery was 0.39 ± 1.03 diopters in Phaco group and 0.25 ± 0.66 diopters in SICS group, p = 0.63. No surgical complications were reported.
Conclusions :
Phaco and SCIS had similar postsurgical BCVA and refractive outcomes in this older population, often with comorbidities like SAH or DM. While Phaco technique demonstrated an excellent, predictable and reproductive visual outcome, SICS showed to be the best choice in patients where the cost is a concern. Therefore, both techniques should be implemented in the Latin America Ophthalmology residence training program.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.