Why do phacoemulsification? Manual small-incision cataract surgery is almost as effective, but less expensive

Ophthalmology. 2007 May;114(5):965-8. doi: 10.1016/j.ophtha.2006.08.057. Epub 2007 Feb 12.


Purpose: To compare the cost of phacoemulsification with foldable lenses with that of manual small-incision cataract surgery (SICS) in a hospital setting.

Design: Average cost comparision between 2 surgical techniques.

Participants: Four hundred patients and 4 surgeons.

Methods: A single masked randomized controlled clinical trial was conducted previously to compare safety and efficacy of the 2 techniques for rehabilitation of the cataract patient. The fixed-facility and recurrent (consumables) cost for phacoemulsification and SICS were calculated based on information collected at different sources using standard norms. Average cost per procedure was calculated by dividing the total cost by the number of procedures performed.

Main outcome measures: Average fixed-facility cost and average consumable cost for both the techniques.

Results: The average cost of a phacoemulsification surgery for the hospital was Indian rupees (Rs) 1978.89 ($42.10), and the average cost for a SICS surgery was Rs 720.99 ($15.34), of which Rs 500.99 ($10.65) was the fixed-facility cost common to both. Phacoemulsification cost was more because of the foldable lens used.

Conclusions: Phacoemulsification needs additional cost for the machine (depreciation), replenishment of parts, and annual maintenance contract. Manual SICS is far more economical than phacoemulsification. Its visual result is comparable with that of phacoemulsification and is as safe.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cataract / rehabilitation*
  • Cataract Extraction / economics*
  • Delivery of Health Care / economics*
  • Health Care Costs*
  • Humans
  • India
  • Lens Implantation, Intraocular
  • Microsurgery / economics*
  • Phacoemulsification / economics*
  • Single-Blind Method
  • Treatment Outcome
  • Visual Acuity