Six years after manual small incision cataract surgery—Perspective from a secondary level eye hospital in Rural India

Purpose:We assessed the long-term impact of manual small incision cataract surgery (MSICS) in rural Central India using patient reported outcomes (PRO).Methods:841 patients undergoing MSICS by a single surgeon from January 2012 to July 2013 were included. The same patients were contacted telephonically in November 2019 and were asked to report their perceived outcome of the cataract surgery. Data on the fellow eye status were also collected. These data were compared with objective data recorded at the time of surgery.Results:The mean age was 61.53 ± 10.9 with 59% women. 96% had presenting visual acuity (VA) ≤5/60. 86% had visually significant cataract in the fellow eye; 2.5% were cataract blind. 85% had unaided VA ≥ 6/18 at 6 weeks. 223 patients were contactable by telephone after 6 years. 55 had expired and their relatives gave the information. Of these, 90% reported “good” outcome. PRO at 6 years and unaided VA at 6 weeks after surgery correlated significantly (P = 0.05). 40% had undergone cataract surgery of the fellow eye in the interim. Of those who reported “not good” outcome, 70% had undergone fellow eye surgery, compared with 38% in those who reported “good” outcome (P = 0.005).Conclusion:Telephonic PRO correlates with unaided VA 6 years after cataract surgery and could replace a follow-up visit. A PRO of poor vision in the already operated eye was the only factor correlating with fellow eye surgery.