Purpose: To compare the outcomes of clear corneal small incision cataract surgery with that of conventional phacoemulsification Methods: This was a prospective study, in which 50 eyes of 50 patients of senile cataract (Up to Grade III nuclear sclerosis) were operated. Cataract associated with glaucoma, corneal pathology, other ocular problem e.g., uveitis, trauma, pseudoexfoliation syndrome etc., & retinal pathology were excluded from study. Cases were selected on alternate basis to have cataract extraction through a temporal clear corneal incision for right eye & nasal for left eye using either clear corneal small incision cataract surgery through a 3.5 mm incision (25 eyes) or conventional phacoemulsification through a 3.5 mm incision (25 eyes).The phacoemulsification system for cataract surgery was Infiniti Vision System (Alcon, USA) and the intraocular lens used was acrylic foldable lens in all patients. Assessed parameters were-1) Uncorrected & best corrected visual acuity, 2) Surgically induced astigmatism, 3) Intraoperative & post-operative complications. Results: The mean uncorrected visual acuity (UCVA) of clear corneal SICS group at 1st post-operative day,1st week,4th week and 6th week were 0.74±0.30, 0.61±0.29, 0.35±0.27 & 0.31±0.27, respectively. Similarly, for phacoemulsification group the mean UCVA at 1st post-operative day, 1st week, 4th week and 6th week were 0.66 ±0.35, 0.51±0.35, 0.30±0.24 & 0.22±0.16, respectively. The mean best corrected visual acuity (BCVA) of clear corneal SICS group at 1st post-operative day, 1st week, 4th week and 6th week were 0.71±0.29, 0.55±0.32, 0.31±0.28 & 0.23±0.34, respectively. Similarly, for phacoemulsification group the mean BCVA at 1st post-operative day, 1st week, 4th week and 6th week were 0.54±0.37, 0.42±0.37, 0.24±0.21 & 0.16±0.13, respectively. The mean surgically induced astigmatism (SIA) of clear corneal SICS group at 1st post-operative day, 1st week, 4th week and 6th week were 2.50±0.68, 2.01±0.52, 1.82±0.86 & 1.34±0.86, respectively. Similarly, for phacoemulsification group the mean SIA at 1st post-operative day, 1st week, 4th week and 6th week were 2.17±0.42, 1.73±0.45, 1.54±0.52 & 1.03±0.63, respectively. Complication rates e.g., striate keratopathy, cells and flare in anterior chamber, are more for clear corneal SICS group patients than phacoemulsification group for initial 1st post op day, 1st week & 2th week; but complications become comparable at 4th week, 6th week post op. One patient in clear corneal SICS group had undergone pseudophakic bullous keratopathy unfortunately. Conclusion: Although conventional phacoemulsification is a safe procedure, has faster visual rehabilitation, minimum complications. But there are no statistically significant differences between clear corneal SICS & conventional phacoemulsification in final outcomes of UCVA, BCVA, SIA & complication rates.
