Document Detail


Extracapsular cataract extraction compared with small incision surgery by phacoemulsification: a randomised trial.
MedLine Citation:
PMID:  11423457     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Cataract extraction constitutes the largest surgical workload in ophthalmic units throughout the world. Extracapsular cataract extraction (ECCE), through a large incision, with insertion of an intraocular lens has been the most widely used method from 1982 until recently. Technological advances have led to the increasing use of phacoemulsification (Phako) to emulsify and remove the lens The technique requires a smaller incision, but requires substantial capital investment in theatre equipment. In this randomised trial we assessed the clinical outcomes and carried out an economic evaluation of the two procedures. METHODS: In this two centre randomised trial, 232 patients with age related cataract received ECCE, and 244 received small incision surgery by Phako. The main comparative outcomes were visual acuity, refraction, and complication rates. Resource use was monitored in the two trial centres and in an independent comparator centre. Costs calculated included average cost per procedure, at each stage of follow up. RESULTS: Phako was found to be clinically superior. Surgical complications and capsule opacity within 1 year after surgery were significantly less frequent, and a higher proportion achieved an unaided visual acuity of 6/9 or better (<0.2 logMAR) in the Phako group. Postoperative astigmatism was more stable in Phako. The average cost of a cataract operation and postoperative care within the trial was similar for the two procedures. With the input of additional spectacles for corrected vision at 6 months after surgery, the average cost per procedure was pound359.89 for Phako and pound367.57 for ECCE. CONCLUSION: Phako is clinically superior to ECCE and is cost effective.
Authors:
D C Minassian; P Rosen; J K Dart; A Reidy; P Desai; M Sidhu; S Kaushal; N Wingate
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The British journal of ophthalmology     Volume:  85     ISSN:  0007-1161     ISO Abbreviation:  Br J Ophthalmol     Publication Date:  2001 Jul 
Date Detail:
Created Date:  2001-06-25     Completed Date:  2001-07-26     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  0421041     Medline TA:  Br J Ophthalmol     Country:  England    
Other Details:
Languages:  eng     Pagination:  822-9     Citation Subset:  IM    
Affiliation:
Institute of Ophthalmology, University College London, UK.
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MeSH Terms
Descriptor/Qualifier:
Aged
Astigmatism / etiology
Cataract Extraction / adverse effects,  economics*
Costs and Cost Analysis
Eyeglasses / economics
Female
Humans
Intraoperative Complications
Male
Phacoemulsification / adverse effects,  economics
Postoperative Care / economics
Treatment Outcome
Visual Acuity
Comments/Corrections
Comment In:
Br J Ophthalmol. 2001 Jul;85(7):765-6   [PMID:  11423441 ]
Erratum In:
Br J Ophthalmol 2001 Dec;85(12):1498

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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