Background: Blindness and visual impairment are public health problems and constitute an important socio-economic burden in sub-Saharan Africa. Understanding the outcomes of cataract surgery will improve our knowledge of risk factors for poor outcomes. Previous studies have focused exclusively on the phacoemulsification technique with limited attention to the extracapsular cataract extraction (ECCE) and manual small incision cataract surgery (MSICS) techniques. Objectives: To compare the cataract surgery outcomes between the ECCE and MSICS techniques. Methods: The study was an observational research design that used the LogMAR visual acuity (VA) chart, subjective refraction, slit lamp and ophthalmoscope to collect data. The participants were followed for a period of six-weeks post-surgery and outcomes were recorded. Data were presented using frequencies, percentages and means ± standard deviation. Results: The sample included 101 participants, with a mean age of 66.32 ± 15.99 years. Fifty and 51 participants had undergone the ECCE and MSICS techniques respectively. Overall, one-hundred participants had poor pre-surgery VA and subjective refractions were generally not possible due to the severity of cataracts present. The mean aided post-surgery VA was 0.31 LogMAR and 0.13 LogMAR in the ECCE and MSICS groups respectively (p < 0.001). The mean post-surgery refractive astigmatism was similar in the ECCE (-2.06 D) and MSICS (-1.80 D) groups (p = 0.110). The spherical equivalence was approximately -0.50 D higher in the MSICS group, but not statistically significant (p = 0.330). Approximately one out of every five participants (n = 21) had post-surgery ocular complications such as corneal opacity and haziness as well as posterior capsular absence. Conclusions: The MSICS technique showed better post-surgery outcomes than the ECCE technique. Keywords: Cataract surgery outcomes; extracapsular cataract surgery; manual small incision cataract surgery; ocular complications.

Background: Blindness and visual impairment have been shown to reduce vision-related quality of life (VRQoL), general health and social status and increase mortality. Understanding the influence of different cataract surgery techniques on VRQoL can enhance the understanding of which technique may be most suitable to achieve the best outcomes from a patient's perspective. Previous studies have focused exclusively on the phacoemulsification technique, with limited attention on other techniques that are common in developing countries, such as the extracapsular cataract extraction (ECCE) and manual small-incision cataract surgery (MSICS) techniques. Aim:To evaluate the impact of cataract surgery on VRQoL for the ECCE and MSICS techniques. Setting:The study was conducted at the Themba Hospital in the Mpumalanga province.Methods: A case study research design was used at the Themba Hospital. Participants underwent either the ECCE or the MSICS technique and were followed for a period of 6-weeks post-surgery. The VRQoL was assessed using the 33-item Indian Vision Functioning Questionnaire (IND-VFQ-33). Data were presented using frequencies, percentages and means ± standard deviations. Results:The sample included 101 participants, with a mean age of ~66 years. Following cataract surgery, there was an increase in the frequency of the 'not at all' response for the majority of the questions in the IND-VQ-33 questionnaire in all three domains. There were statistically significant differences (p < 0.05) between the pre-surgery and post-surgery mean scores for all the questions, with the exceptions being those related to problems experienced when seeing outside in bright sunlight, bright light hurting the eyes and closing the eyes because of light from vehicles. Conclusion:Individuals who underwent both the ECCE and MSICS techniques showed improvement in VRQoL in terms of general functioning, psychosocial impact and vision symptoms domains.