Randomized Controlled Trial of varied incision sites in Manual Small Incision Cataract Surgery done in a Medical College Hospital in Kancheepuram District, Tamil Nadu, India

Aim: To compare visual outcome, postoperative surgically induced astigmatism (SIA), andpostoperative complications of superior and temporal scleral incision in manual small incisioncataract surgery (MSICS). Materials and Methods: A Prospective Randomized, parallel-group,active-controlled Trial Study of 80 cases of senile/pre-senile cataract. 40 cases were randomlyassigned (computer-generated randomization) to superior incision and 40 cases to the temporalincision. Results: The majority of patients (38 patients- 47.5%) were in the age group of 56-65years. The next common age group was 66-75 years(31 patients-38.75%). In the superior MSICSgroup, the majority of patients (28 patients-70%) had a moderate post-operative unaided visualacuity of 6/18-6/12. In the temporal MSICS group, majority of patients(33patients-82.5%) had agood post-operative unaided visual acuity of 6/9-6/6. The mean surgically induced astigmatism(SIA)in the superior MSICS group was 1.12 and in the temporal MSICS group was 0.45 with a differenceof 0.67. The SIA values were analyzed using the unpaired T-test which showed a value of 9.967which was statistically significant(P value of 0.0001). Conclusion: This study has shown that thetemporal approach for Manual small incision cataract surgery(MSICS) has less postoperativeastigmatism and better postoperative unaided visual acuity compared to the superior approach.