Is manual small incision cataract surgery affordable in the developing countries? A cost comparison with extracapsular cataract extraction.

AIM To compare the cost of manual small incision cataract surgery (MSICS) with conventional extracapsular cataract surgery (ECCE) in community eye care settings. METHOD A single masked randomised trial was used to compare the safety, efficacy, time, and patient satisfaction of surgery by both the techniques. The fixed facility and recurrent cost for the two procedures was calculated based on information collected from different sources. Average cost per procedure was calculated by dividing the total cost by the number of procedures performed. RESULT The average cost of an ECCE procedure for the hospital was Rs 727.76 (US$15.82) and the average cost of a MSICS procedure was Rs 721.40 ($15.68), of which Rs. 521.51 ($11.34) was the fixed facility cost common to both. CONCLUSION Both ECCE and MSICS are economical in community eye care settings, but MSICS is economical and gives better uncorrected visual acuity in a greater proportion of patients.