Comparison of Visual Outcomes After Manual Small Incision Cataract Surgery and Phacoemulsification at Lagos University Teaching Hospital

Cataract surgery is the most effective and cost-efficient intervention for reversible blindness, but the comparative visual outcomes of manual small incision cataract surgery (MSICS) and phacoemulsification in the Nigerian setting are insufficiently documented. This retrospective cohort study compares visual acuity outcomes, complication rates, and astigmatism induction between patients who underwent MSICS and those who received phacoemulsification at the Lagos University Teaching Hospital (LUTH), Lagos State, South West Nigeria. A review of surgical records from 400 eyes (200 per technique) over a three-year period will be conducted. Primary outcome measures include best-corrected visual acuity at one month and three months post-operatively, keratometric astigmatism, and intraoperative and postoperative complication rates. Secondary outcomes include surgical duration and cost of procedure. Analysis will involve independent t-tests, chi-square tests, and multivariable regression. The study expects to find comparable visual acuity outcomes between both techniques, with MSICS demonstrating lower direct costs but slightly higher post-operative astigmatism. Findings will contribute to the clinical decision-making literature for cataract surgery in resource-constrained settings and will be submitted to the LUTH ophthalmology department and the Ophthalmic Society of Nigeria to inform surgical training programs. Keywords: cataract surgery, phacoemulsification, MSICS, visual outcomes, Lagos University Teaching Hospital