Comparison of the Outcomes of Manual Small Incision Cataract Surgery (MSICS) and Phacoemulsification (PHACO) in Ghana

  • Samuel Kyei
  • Ebenezer Zaabaar
  • Frank Assiamah
  • Michael Agyemang Kwarteng
  • Kofi Asiedu
Keywords: Cataract, postoperative visual acuity, postoperative complications, total astigmatic change


Background: The growing middle-class population of Ghana has seen more people being employed in visually demanding occupations  and hence there is an increased desire for quality post-cataract surgical visual outcomes. This study aimed at comparing the outcomes of manual small incision cataract surgery (MSICS) and phacoemulsification (PHACO) among Ghanaians.

Methods: This was a retrospective cross-sectional study in which records of patients who underwent MSCIS or phacoemulsification by the same surgeon were reviewed.

Results: Medical records of 248 eyes were reviewed, out of which 132 underwent PHACO and 116 had MSICS. A significant number of the  PHACO group had good (6/6–6/18) uncorrected visual acuity (UCVA) compared to the MSICS group at 1–2 weeks follow-up (p = 0.003) and 4–6 weeks follow-up (p = 0.002). MSICS resulted in a higher total astigmatic change compared to PHACO (p < 0.001). The PHACO group
had a higher number of postoperative complications compared with the MSICS group (p <0.001). Postoperative borderline and poor  uncorrected visual acuity were associated with age, total astigmatic change, and postoperative complications.

Conclusion: The postoperative UCVA outcomes at 4–6 weeks’ follow-up indicates that PHACO resulted in noticeably less spectacle dependency when compared to MSICS.


Journal Identifiers

eISSN: 2523-0816
print ISSN: 1999-9674