Intraocular pressure reduction following phacoemulsification and manual small-incision cataract surgery: A narrative review

ABSTRACT Cataract surgery not only restores visual acuity but also has a significant impact on intraocular pressure (IOP), a critical factor in the management of glaucoma and ocular hypertension. Among the widely practised techniques, phacoemulsification and manual small-incision cataract surgery (MSICS) have both been shown to reduce IOP postoperatively. This narrative review aims to examine and compare the mechanisms, extent, and clinical implications of IOP reduction following these two surgical methods. Phacoemulsification typically results in a more predictable and sustained IOP decrease, particularly beneficial in glaucomatous eyes, whereas MSICS offers a comparable effect with added advantages in cost-effectiveness and accessibility. The review highlights that both techniques play an essential role in the dual management of cataract and elevated IOP, especially in diverse healthcare settings. By synthesizing evidence from multiple studies, this review provides insights to guide surgical decision-making tailored to patient needs and resource availability.