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

Samuel Kyei1, Ebenezer Zaabaar1, Frank Assiamah1, Michael Agyemang Kwarteng2, Kofi Asiedu3

1.Department of Optometry and Vision Science, School of Allied Health Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
2.Discipline of Optometry, University of KwaZulu-Natal, Durban, South Africa
3.Cosmopolitan Medical Center, Dzorwulu, Accra, Ghana

Correspondence to: Dr. Samuel Kyei; Email:

Received: 15th September 2020; Revised: 9th January 2021; Accepted: 3rd February 2021; Available online: 9th March 2021

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.

Keywords: Cataract, postoperative visual acuity, postoperative complications, total astigmatic change

Conflicts of Interest: None
Funding: None

© 2021 Author. This work is licensed under the Creative Commons Attribution 4.0 International License.


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