Research Article

A Comparative Study of Anatomic and Functional Outcomes of Two Surgical Techniques of Cataract at Lome

Ayena KD*, Santos KAM, Vonor K, Amedome KM, Wodome A, Strauss G, Nagbe YE, Koffi-Ametooyona A and Balo K

Published: 02/17/2017 | Volume 1 - Issue 1 | Pages: 001-008


Aim: To compare the anatomical and functional outcomes of cataract surgery with manual small incision cataract surgery (MSICS) to those of extracapsular cataract extraction (ECCE) in Lome.

Patients and Methods: A prospective study involved two groups of patients who underwent ECCE (group 1) and MSICS (group 2) by the same surgeon in the same conditions in different periods. Complications and visual results to the 45th postoperative day were compared.

Results: At the 45th postoperative day, 60% of operated eyes of the ECCE group (G1) and 83.9% in the group of MSICS (G2) had uncorrected visual acuity greater than or equal to 3/10. Through the pinhole, these proportions increased to 73.3% for G1 and 92.2% for G2. Visual acuity was less than 1/10 in 4.4% for G1 and 1.1% for G2. The vitreous loss was observed in proportions of 3.8% for G1 and 3.3% for G2. During follow-up, the three main early postoperative complications were inflammation (13.9%), corneal edema (13.3%), and the pigment dispersion (7.2%) in G1 and corneal edema (9.4%), pigment dispersion (8.3%) and hypertonia (6.6%) in G 2.

Conclusion: Two cataract extraction techniques offer the same level of safety in intraoperative period. However, MSICS has certain advantages over the ECCE and would be an alternative technique in developing countries.

Read Full Article HTML DOI: 10.29328/journal.hceo.1001001 Cite this Article


  1. Foster A, Gilbert C, Johnson G. Changing patterns in global blindness: 1998-2008. Community Eye Health. 2008; 21: 37-39. Ref.:
  2. Ndiaye PA, El Amary K, Seye-Ndiaye C, Demeideros M, Wane AM, et Al. [Scleral mini-incision without ultrasound in the treatment of congenital cataract]. J Fr Ophtalmol. 1999; 22: 347-351. Ref.:
  3. Ang M, Evans JR, Mehta JS. Manual small incision cataract surgery (MSICS) with posterior intraocular lens versus extracapsular cataract extraction (ECCE) with posterior intraocular lens for age-related cataract. Cochrane Database Sys Rev. 2012; 18: CD008811. Ref.:
  4. Muhammad TK, Sanaullah J, Zakir H, Samina K, Muhammad KK, et al. Visual outcome and complications of manual sutureless small incision cataract surgery. Pak J Ophthalmol. 2010; 26: 32-38. Ref.:
  5. Ruit S, Tabin G, Chang D, Bajracharya L, Kline DC, et al. A prospective randomized clinical trial of phacoemulsification vs manual sutureless small-incision extracapsular cataract surgery in Nepal. Am J Ophthalmol. 2007; 143: 32-38. Ref.:
  6. Sherwin JC, Dean WH, Schaefers I, Courtright P, Metcalfe N. Outcomes of manual small-incision cataract surgery using standard 22 dioptre intraocular lenses at Nkhoma Eye Hospital, Malawi. Int Ophthalmol. 2012; 32: 341-347. Ref.:
  7. Tabin G, Chen M, Espandar L. Cataract surgery for the developing world. Curr Opin Ophthalmol. 2008; 19: 55-59. Ref.:
  8. Gogate PM, Deshpande M, Wormald RP, Deshpande R, Kulkarni SR. Extracapsular cataract surgery compared to manual small incision cataract surgery in community eye care setting in western India: a randomized controlled trial. Br J Ophthalmol. 2003; 87: 667-672.
  9. Ayena KD, Billong J, Vonor K, Diallo JW, Santos MAK, Maneh N, et al. Assessment of astigmatism in manual and sutureless small incision cataract surgery. New Front Ophthalmol 2015; 1: 14-17. Ref.:
  10. de la Cataracte C. In John Sandford-Smith. Chirurgie oculaire sous les climats chauds. Traduit par Olivier Collin et Paddy Ricard. ICEH, Londres, 2006: 81-200.
  11. George R, Rupauliha P, Sripriya AV, Rajesh PS, Vahan PV, et al. Comparison of endothelial cell loss and surgically induced astigmatism following conventional extracapsular cataract surgery, manual small incision surgery, and phacoemulsification. Ophthalmic Epidemiol. 2005; 12: 293-297. Ref.:
  12. Gurung A, Karki DB, Shreshta S, Rijal AP. Visual outcomes of conventional extracapsular cataract extraction with posterior chamber intraocular lens implantation versus manual small incision cataract surgery. Nep J Ophthalmol. 2009; 1: 13-19. Ref.:
  13. Sharma RL, Mahajan D, Sharma K. SICS tunnel construction with oblique limbal stab incision and its effectiveness in self-sealing, nucleus delivery and astigmatism minimal duration cataract surgery. J Ocul Dis Therapeut. 2014; 2: 55-63. Ref.:
  14. Gogate PM, Kulkani SR, Krishnaiah S, Deshpande RD, Joshi SA, et al. Safety and efficacy of phacoemulsification compared with manual small-incision cataract surgery by a randomized controlled clinical trial: six week results. Ophthalmology. 2005; 112: 869-874. Ref.:
  15. Devendra J, Agarwal S, Singh PK. A comparative study of clear corneal phacoemulsification with rigid IOL versus SICS; the preferred surgical technique in low socio-economic group patients of rural areas. J Clin Diagnos Res. 2014; 8: 1-3. Ref.:
  16. Khandekar RB, Jain BK, Sudhan AK, Pandey KP. Visual acuity at 6 weeks after small incision cataract surgery and role of audit in predicting visual acuity. Eur J Ophthalmol. 2010; 20: 345-352. Ref.:
  17. Shah SP, Gilbert CE, Razavi H, Turnerb EL, Lindfield RJ. Preoperative visual acuity among cataract surgery patients and countries’ state of development: a global study. Bull World Health Organ. 2011; 89: 749-756. Ref.:
  18. Hennig A. Chirurgie de la cataracte sans suture et sans phacoémulsification: une solution pour réduire la cécité par cataracte dans le monde? RSOC. 2005; 2: 4-5. Ref.:
  19. Amza A, Djibo H, Yacoubou S, Abdoulaye SH. Résultats de la chirurgie de la cataracte par la technique de phacoalternative au Niger. Ann Univ Abdou Moumouni. 2011; XII-A: 49-56.
  20. Lindfield R, Kuper H, Polack S, Eusebio C, Mathenge W, et al. Outcome of cataract surgery at one year in Kenya, the Philippines and Bangladesh. Br J Ophthalmol. 2009; 93: 875-880. Ref.:
  21. Venkatesh R, Muralikrishnan R, Balent LC, Prakash SK, Prajna NV. Outcomes of high volume cataract surgeries in a developing country. Br J Ophthalmol. 2005; 89: 1079-1083. Ref.:
  22. Shah SP, Gilbert CE, Razavi H, Turnerb EL, Lindfield RJ. Preoperative visual acuity among cataract surgery patients and countries’ state of development: a global study. Bull World Health Organ. 2011; 89: 749-756. Ref.:
  23. Limburg H, Foster A, Vaidyanathan K, Murthy GV. Monitoring visual outcomes of cataract surgery in India. Bull World Health Organ. 1999; 77: 455-460. Ref.:
  24. Gogate PM, Deshpande M, Wormald RP. Is manual small incision cataract surgery affordable in the developing countries? A cost comparison with extracapsular cataract extraction. Br J Ophthalmol. 2003; 87: 843-846. Ref.:
  25. Trivedy J. Outcomes of high volume cataract surgeries at a Lions Sight First Eye Hospital in Kenya. Nepal J Ophthalmol. 2011; 3: 31-38. Ref.: