Sutureless ECCE faster, cheaper, more effective than phaco

LAS VEGAS — Manual, sutureless small incision extracapsular cataract extraction is more affordable than standard phacoemulsification and may be more effective, a recent study by researchers in Nepal suggests.

Geoffrey C. Tabin, MD, presented the results of a randomized study comparing the two approaches to cataract surgery in 108 patients here at the American Academy of Ophthalmology meeting.

In 80% of patients who completed 1-year follow-up exams, the researchers found that 77.8% of phacoemulsification-treated patients achieved 20/60 vision compared to 90% of patients who received manual small incision sutureless extracapsular cataract extraction (ECCE), Dr. Tabin said. ECCE patients also had less edema and haze.

In addition to being more effective than phacoemulsification in developing nations, sutureless ECCE is more cost effective, Dr. Tabin added.

"Phacoemulsification is considered the standard of care for best cataract [surgery] results, but the availability and expense in obtaining the equipment for developing countries is difficult, and maintaining the equipment is difficult," he said.

He explained that initial start-up costs in attaining a phacoemulsification system exceed $100,000 compared to just $10,000 for the manual surgery approach. Per case, phacoemulsification costs $150, while sutureless ECCE costs $15. Also, sutureless ECCE takes on average 9 minutes to complete compared to 15 minutes for phacoemulsification, Dr. Tabin said.

"The cost is dramatically better. The safety is equivalent. The efficiency is better, considerably," Dr. Tabin said. "We are very encouraged by our results."