A comparative study of astigmatism following manual small incision cataract surgery and conventional extracapsular cataract extraction at a tertiary centre in northern india

Sajad Khanday, Raashid Maqbool Wani, Rahila Ramzan, Farooq Runyal


Objective: To compare the surgically induced astigmatism following two different techniques of cataract surgery-manual SICS (Small Incision Cataract Surgery) and standard ECCE (Extra-Capsular Cataract Extraction). Materials and Methods: Subjects consisted of patients, aged 10-80 years, from both sexes and divided into two groups of 100 each (one eye per patient). One group was operated with manual SICS and the other with standard ECCE technique. Results: The mean surgically induced astigmatism (SIA) in the SICS group during the sixth week postoperative follow up was found to be 0.66D ± 0.60 SD (Standard Deviation) compared to 2.25D ± 1.23 SD in the ECCE group. At 6th week follow up, no patient in the SICS group had SIA more than 3D whereas in the ECCE group 30% of the patients had astigmatism >3 D. The induced astigmatism between the two groups had a p-value of <0.001 which is highly significant. Conclusions: It is concluded that SICS induces less surgically induced astigmatism, less inflammation, less complications influencing the overall visual prognosis and quick stabilization of refraction, hence providing better and rapid visual rehabilitation in the postoperative period as compared to the patients in the ECCE group.

Full Text:



Brian G, Taylor H. Cataract blindness challenges for the 21st century. Bull World Health Organ 2001; 79:249-56.

Venkatesh R, Das M, Prashanth S, Muralikrishnan R. Manual small incision cataract surgery in eyes with white cataracts. Indian J Ophthalmol. 2005; 53(3):173-6

Gogate PM, Deshpande M, Wormald RP. Is manual small incision cataract surgery affordable in the developing countries? A cost comparison with extra-capsular cataract extraction. Br J Ophthalmol. 2003 Jul; 87 (7):843–6.

Kelman CD. Phacoemulsification and aspiration: a new technique of cataract removal: a preliminary report. Am J Ophthalmol. 1967 Jul;64(1):23-35.

Colvard DM, Kratz RP, Mazzocco TR, Davidson B. Clinical evaluation of the Terry surgical keratometer. J Am Intraocul Implant Soc. 1980 Jul;6(3):249-51.

Girard LJ, Hoffman RF. Scleral tunnel to prevent induced astigmatism. Am J Ophthalmol. 1984 Apr;97(4):450-6.

Blumenthal M, Ashkenazi I, Assia E, Cahane M. Small incision manual extracapsular cataract extraction using selective hydrodissection. Ophthalmic Surg. 1992 Oct;23(10):699-701.

Myron Yanoff, Jay S. Duker. Data collection and analysis. Ophthalmology. Myron yanoff 1999; 4.33;2.

Ravi Thomas, Aby Jacob, Thomas George. Small incision cataract surgery. Recent advances in Ophthalmology, HV Nema 1996; 3: 57-74.

Burgansky Z, Isakov I, Avizemer H, Bartov E. Minimal astigmatism after sutureless planned extracapsular cataract extraction. J Cataract Refract Surg. 2002 Mar;28(3):499-503.

Kimura H, Kuroda S, Mizoguchi N, Terauchi H, Matsumura M, Nagata M. Extra-capsular cataract extraction with a sutureless incision for dense cataracts. J Cataract Refract Surg. 1999 Sep;25(9):1275-9.

Richard L. Lindstrom. Control of Astigmatism in the cataract patient. Cataract surgery- technique, complications and management. Steinert 1995; 232.

Oshika T, Sugita G, Tanabe T, Tomidokoro A, Amano S. Regular and irregular astigmatism after superior versus temporal scleral incision cataract surgery. Ophthalmology 2000 Nov;107 (11):2049-53.

Ernest PH, Lavery KT, Kiessling LA. Relative strength of scleral tunnel incisions with internal corneal lips constructed in cadaver eyes. J Cataract Refract Surg. 1993 Jul;19(4):457-61.

KPS Malik, Ruchi Goel. Manual small incision cataract surgery. All India ophthalmological society CME; 8: 1-31.


  • There are currently no refbacks.