Visual Outcome and Major Surgical Complications of Phacoemulsification versus Manual Small Incision Cataract Surgery Performed by Resident Doctors at a Regional Institute of Ophthalmology

Introduction: Cataract is the most frequently performed surgery in the world. The beginner cataract surgeon at our institute is first trained in extra capsular cataract extraction followed by training in manual small incision cataract surgery. Once trained in these two surgical arts, the surgeon is then step wise graduated to doing phacoemulsification. We designed a study to compare the major surgical complications and visual outcome of Phacoemulsification versus MSICS performed by resident doctors at our centre. Aim: The aim of the study was to compare the visual outcome and major surgical complications of Phacoemulsification versus Manual Small Incision Cataract Surgery (MSICS) performed by resident doctors at our Western Regional Institute of Ophthalmology. Methods: 253 eyes of 203 patients with visually significant cataract presenting to our outpatient department wer enrolled. The study was carried out at our Regional Institute of Ophthalmology. The study design is a prospective, non-randomized cohort study. Informed consent for cataract surgery was taken from every patient. The data of consecutive resident phacoemulsification and manual small incision cataract surgeries done from December 2017 to February 2018 was analyzed. Phacoemulsification was done by post Master of Surgery JR4. MSICS was done by JR3 and JR2. Results: Both the surgeries in all the three resident groups had good visual outcome. The rate of major surgical complications was 3.70%for JR4 performing phacoemulsification,2.6%and 5.74% for JR3 and JR2 respectively performing MSICS. The overall major surgical complication rate for MSICS was 4.52%. Conclusion: We conclude that Phacoemulsification and MSICS can be taught to resident doctors with good visual results and a comparable rate of major surgical complications. The beginner resident surgeon graduates comfortably from MSICS to phacoemulsification with low complication rates and good visual results.