Competing/conflicts of interest: No stated conflict of interest.
Phacoemulsification versus manual small-incision cataract surgery for age-related cataract: meta-analysis of randomized controlled trials
Article first published online: 4 FEB 2013
© 2012 The Authors. Clinical and Experimental Ophthalmology © 2012 Royal Australian and New Zealand College of Ophthalmologists
Clinical & Experimental Ophthalmology
Volume 41, Issue 4, pages 379–386, May/June 2013
How to Cite
Zhang, J.-y., Feng, Y.-f. and Cai, J.-q. (2013), Phacoemulsification versus manual small-incision cataract surgery for age-related cataract: meta-analysis of randomized controlled trials. Clinical & Experimental Ophthalmology, 41: 379–386. doi: 10.1111/j.1442-9071.2012.02868.x
Funding sources: No stated funding sources.
- Issue published online: 5 JUN 2013
- Article first published online: 4 FEB 2013
- Accepted manuscript online: 7 SEP 2012 06:47AM EST
- Manuscript Accepted: 17 AUG 2012
- Manuscript Received: 20 MAR 2012
- small-incision cataract surgery
To compare outcomes of phacoemulsification (PE) with manual small-incision cataract surgery (MSICS) for age-related cataract.
Patients from previously reported randomized controlled trials (RCTs) of PE and MSICS with clinical outcomes.
A comprehensive literature search of Cochrane Library, PubMed and EMBASE to identify relevant RCTs comparing PE and MSICS. A meta-analysis was performed on the results and a RevMan 5.0 software (version 5.0; Cochrane Collaboration, Oxford, UK) was used for data analysis.
Main Outcome Measures
Primary outcome measures included best corrected vision acuity (BCVA), uncorrected visual acuity (UCVA). Secondary outcome measures included surgically induced astigmatism (SIA), percentage of endothelial cell count (ECC) loss and complications.
Six RCTs describing a total of 1315 eyes were identified. There were no significant differences between the techniques regarding the BCVA 6/9 or better (P = 0.69) and less than 6/18 (P = 0.68), percent of ECC loss (P = 0.45), intraoperative or postoperative complications (P = 0.44 and P = 0.87, respectively). However, a greater proportion of patients in the PE group had final UCVA ≥ 6/9 (P = 0.03), whereas a greater proportion of patients in the MSICS group had final UCVA < 6/18 (P = 0.03). Moreover, PE group induced less SIA (P < 0.00001).
PE is superior to MSICS in UCVA and causes less SIA, but there were no significant differences in visual rehabilitation, ECC loss and complication rates between the two techniques.