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Phacoemulsification versus manual small‐incision cataract surgery for age‐related cataract: meta‐analysis of randomized controlled trials
Author(s) -
Zhang Jiayu,
Feng Yifan,
Cai Jianqiu
Publication year - 2013
Publication title -
clinical and experimental ophthalmology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.3
H-Index - 74
eISSN - 1442-9071
pISSN - 1442-6404
DOI - 10.1111/j.1442-9071.2012.02868.x
Subject(s) - medicine , phacoemulsification , randomized controlled trial , cataract surgery , cochrane library , visual acuity , ophthalmology , meta analysis , astigmatism , surgery , physics , optics
Background To compare outcomes of phacoemulsification ( PE ) with manual small‐incision cataract surgery ( MSICS ) for age‐related cataract. Design Meta‐analysis. Participants Patients from previously reported randomized controlled trials ( RCTs ) of PE and MSICS with clinical outcomes. Methods A comprehensive literature search of C ochrane L ibrary, 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. Results 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). Conclusions 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.