Comparative Analysis of Patient-Reported Outcome Measures in Manual Small-Incision Cataract Surgery Versus Phacoemulsification for Brown Cataracts

Objective The objective of this study is to compare patient-reported outcome measures using the Catquest Questionnaire in patients undergoing phacoemulsification (Phaco) versus manual small-incision cataract surgery (MSICS). Materials and methods This descriptive cross-sectional study included patients aged 40 years and older with cataracts classified as nuclear sclerosis (NS) grade 3 or higher. Demographic details were recorded and a comprehensive ophthalmological exam was done. All patients were operated on by the same surgeon, with 41 undergoing MSICS and 40 undergoing Phaco. Monofocal intraocular lenses were implanted in all cases. Responses to the Catquest questionnaire were collected preoperatively and at six weeks postoperatively. The questionnaire, validated in the Odia language, was provided to patients in both Odia and English. Results Out of 81 patients, 32 underwent their first eye surgery while 49 had their second eye surgery. Both Phaco and MSICS procedures showed significant visual acuity improvement. Mean visual acuity improved from 1.19 to 0.37 in the right eye and from 0.74 to 0.35 in the left eye, with p-values <0.001. Nearly all patients experienced better near vision postoperatively, with 45 (97.8%) of right eyes and 34 (100%) of left eyes achieving near vision between N6 and N8. One Phaco patient with age-related macular degeneration had near vision limited to N10. In a few areas, such as carrying out hobbies, doing needlework, and overall vision satisfaction, patients in the MSICS group patients did better than Phaco group. Response to other questions showed similar responses in both the Phaco and MSICS groups. Conclusion Cataract surgery irrespective of procedure improves overall vision-specific functioning and quality of life. MSICS is often preferred over Phaco for its speed, cost-effectiveness, and lower technological dependence, especially for brown cataracts and bulk surgeries. The choice between MSICS and Phaco should depend on patient needs, preoperative counseling, surgeon expertise, and resources.