EVALUATION OF ASTIGMATISM IN PATIENTS AFTER PHACOEMULISFICATION AND MANUAL SMALL-INCISION CATARACT SURGERY AT KGN-TH, BANNU, KPK

Background: The frequency of cataract-related blindness, underscores the need for cost effective surgical interventions, its adoption in scanty resources setting is hampered by cost and technical challenges. Manually performed small-incision tunnel cataract surgery has become evident as an economical substitute compared to phacoemulisfication but with fewer complications. However, variations in surgical practices exist between high-income and low-income regions, impacting post-operative outcomes. Objectives: To determine visual rehabilitation, safety, and an effectiveness of phacoemulisfication compared to MSICS in causing astigmatism afterward surgery. Materials and Methods: This comparative study used non-probability sequential sampling to assess outcomes of MSICS [169 eyes (50.14%)] in Group A and PHACO [168 eyes (49.85%)] in-group B, out of 337 cataract patients. Inclusion Criteria is Adults with lenticular cataract and keratometric astigmatism ≤2.00 D and Exclusion Criteria is History of glaucoma, corneal scarring, prior ocular surgery, or astigmatism >2.00 D. Results: Results of both techniques indicate comparable improvements in visual acuity, with advantages in intraoperative time and post-operative corrected visual acuity observed in the manually performed small incision tunnel cataract surgery (MSICS) group. Our findings about astigmatism correction at six month was 1.18±0.32D in MSICS surgery group while 1.20±0.22D in PHACO group. Mean intraoperative time for MSICS group was significantly shorter than PHACO group (8.5±3.2 vs 12.5±5.6,p<0.001) Conclusion: PHACO and MSICS both successfully increase visual acuity, but MSICS has a slight advantage in correcting astigmatism and requires less time during surgery. MSICS is still a useful option, particularly in environments with limited resources, highlighting the necessity of more research to lessen blindness caused by cataracts.