Comparison of visual acuity between phacoemulsification and extracapsular cataract extraction: a systematic review and meta-analysis

Background: Surgical treatment is the primary intervention for cataracts. Extracapsular cataract extraction (ECCE) is a routine surgery for cataracts, phacoemulsification (PE) is another procedure with a small incision and injury area. This study investigated the comparison of the effects of these two procedures on the patient's visual acuity. Methods: Embase, PubMed, Cochrane Library, and SpringerLink databases were searched from January 2000 to August 2021 to obtain randomized controlled trial (RCT) studies of PE and ECCE procedures for cataract in English. After the initial screening, Revman 5.4 software was used for the meta-analysis. Results: This meta-analysis included a total of eight articles with 1,015 affected eyes. The results showed that the rate of good final visual acuity in the PE group was higher than that in the ECCE group [odds ratio (OR) =2.94, 95% confidence interval (CI): 2.17-3.99, P<0.00001], the incidence of vitreous Loss during PE surgery was lower than that in ECCE surgery (OR =0.16, 95% CI: 0.04-0.64, P=0.01), as was the incidence of capsular tear (OR =0.29, 95% CI: 0.10-0.85, P=0.02), the incidence of capsule opacification after surgery (OR =0.20, 95% CI: 0.08-0.53, P=0.001), and the incidence of cystoid macular edema after surgery (OR = 0.16, 95% CI: 0.04-0.74, P=0.02). Discussion: Compared with ECCE, PE demonstrates an improvement in postoperative visual acuity and has fewer complications for cataract patients.