The small incision manual cataract surgery for hard nucleus cataract——the superiority on improvement of quality of visual acuity and life

Objective To observe the visual acuity, corneal astigmatism and quality of life of patients with hard nucleus cataract after small incision manual nuclear extraction (non-phacoemulsification). Methods Prospective cohort study.Total of 440 eyes of 440 cases with hard nucleus cataract from Jan.2014 to Jan.2019 in Yuyao Maternal and Child Health Hospital were randomly divided into two groups.There were 198 cases in small incision manual nuclear extraction group (manual group) and 242 cases in phacoemulsification group (phaco group). Follow-up time was 3 months. Results At 1 month after operation, the complication rate in the manual group was lower than that in the phaco group (P=0.028). At 3 months after operation, there was no significant difference in distribution of uncorrected visual acuity between the two groups (P=0.776, 0.712, 0.810). The corneal astigmatism of the manual group was lower than that of the phaco group (P=0.000). There was no significant difference in general health status, far work, ophthalmodynia, social function, social role limitation, independence, or mental health questionnaire score between the two groups (P=0.230, 0.601, 0.259, 0.296, 0.544, 0.492, 0.547). The score of overall vision, near work, color vision and peripheral vision in the manual group were higher than those of the phaco group (P=0.000). Conclusion Small incision manual cataract surgery for the treatment of hard nucleus cataract can not only improve the visual acuity, but also reduce corneal astigmatism and the incidence of complications, and improve the visual related quality of life of patients. Key words: Cataract, hard nucleus; Delivery, nucleus, manual, non-phacoemulsification, small incision; Phacoemulsification; Quality of life