COMPARATIVE ANALYSIS OF SURGICALLY INDUCED ASTIGMATISM AND VISUAL OUTCOMES: MANUAL SICS VS PHACOEMULSIFICATION IN HARD NUCLEAR CATARACTS

Background: Hard nuclear cataracts pose surgical challenges, especially in developing countries. Purpose: To compare surgically induced astigmatism (SIA) and visual outcomes between Manual Small Incision Cataract Surgery (SICS) and phacoemulsification.

Methods: A prospective comparative study was conducted on 100 patients with grade III-V nuclear cataracts. Patients were divided into two groups:SICS (n=50) and phacoemulsification(n=50). Postoperative visual acuity and SIA were assessed at 1 week and 6 weeks.

Results: Early postoperative visual acuity was significantly better in the phacoemulsification group. Mean SIA was higher in SICS (1.3 - 0.3 D) compared to phacoemulsification (0.6 - 0.2 D) (p < 0.05). At 6 weeks, final visual outcomes were comparable between both groups. Conclusion: Phacoemulsification provides faster visual recovery with lower SIA; however, SICS remains a safe and cost-effective alternative with comparable final outcomes.