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Manual small-incision cataract procedures offer affordable, high-volume surgery with good results
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HONG KONG — Manual small-incision cataract surgery is not only cost-effective, but it also allows for high patient turnover with good visual results, a surgeon said here.
The Aravind Eye Hospital sees eight to 10 cataract patients per hour with the technique, for a total of 45 to 60 patients in 6 hours. The higher patient volume allows for more effective and safe cataract extraction procedures to be performed at the hospital on a daily basis, R.D. Ravindran, MS, DO, said.
Dr. Ravindran, who is joint director and chief medical officer of Aravind Eye Care System, presented results from the hospital's experience with manual small-incision cataract surgery (SICS) and standard extracapsular cataract extraction (ECCE) at the World Ophthalmology Congress.
"SICS has emerged as an affordable alternative to instrumental phaco," he said. "There's nearly comparable results as far as visual outcomes are concerned."
At Aravind Eye Hospital in 2008, 53,475 patients paid for procedures, and 127,587 patients had their cataracts removed without a fee, he said.
Because both manual SICS and ECCE are low-cost procedures, they are excellent choices for patients who cannot afford phacoemulsification, Dr. Ravindran said. For those who can afford phaco, the procedures are also sometimes a better choice than standard phaco, he said.
"Even for patients who can pay, they are an ideal choice for advanced cataracts," he said.
He said results from a study by Parikshit Gogate, MS(Ophth), and colleagues that looked at 1,424 cases in a masked clinical trial showed that manual SICS has good visual results when compared with phaco.
In the study, 372 patients of 400 patients completed 6 weeks of follow-up. Patients were randomized to either phaco or manual SICS. Of those patients, 68% in the phaco group and 61% of those in the manual SICS group had uncorrected visual acuity better than or equal to 6/18 at 1 week.
At 6 weeks follow-up, 81% of the phaco group and 71% of the manual SICS group had visual acuity better than or equal to 6/18, the study said.