Comparative analysis of the efficacy of small incision cataract surgery and phacoemulsification for the treatment of tibetan cataract patients

AIM:To analyze the postoperative visual acuity, and preoperative and postoperative complications in cataract patients in Tibet Plateau area who received small incision cataract extraction without phacoemulsification as compared to in those who received phacoemulsification. <p>METHODS:Four hundred and thirteen cataract patients admitted to ophthalmology departments in traditional Tibetan medicine hospital in Tibet Autonomic Region from October 2014 to January 2015 were collected. They were randomized into the group(200 patients with 200 eyes)receiving phacoemulsification combined with intraocular lens implantation as Phaco group and the group(213 patients with 213 eyes)receiving small incision cataract extraction combined with intraocular lens implantation as small incision group. The two groups were compared for uncorrected visual acuity at 1 and 5d postoperatively, and the preoperative and postoperative complications. <p>RESULTS:At 1 and 5d postoperatively, there were 150 eyes(70.4%)and 196 eyes(92.0%)with visual acuity ≥0.5 in the small incision group, respectively. There were 156 eyes(78.0%)and 185 eyes(92.5%)in the Phaco group. The difference value of visual acuity before and at 1d after the operation of Phaco group was higher than that of small incision group(<i>P</i><0.05); while the difference value of visual acuity between 5d and 1d after the operation showed no different between Phaco group and small incision group(<i>P</i>=0.33). According to Emery Standard, the number of eyes with visual acuity ≥0.5 showed no statistically significant differences between two groups in the patients with nuclear-grade I, Ⅳ and Ⅴ(<i>P</i>>0.05); however, it was statistically significant differences between two groups in the patients with nuclear-gradeⅡ and Ⅲ(<i>P</i><0.01). But there was no statistical significance for corneal edema or iris reaction between the two groups(<i>P</i>>0.05).<p>CONCLUSION:This study showed that age-relative cataract is still one of the most common pathogenesis in Tibet. Surgery is the only option for the best treatment effect so far. On postoperative 1d, the visual acuity of the patients with nuclear-gradeⅡ and Ⅲ in the Phaco group improved more than those in the small incision group. While, there was no significant difference in patients with nuclear-grade I, Ⅳ and Ⅴ. No differences were found on corneal edema, iris reaction or other complications. Therefore, small incision cataract extraction can achieve similar effect in the absence of condition for phacoemulsification