Small incision cataract surgery (SICS) is one of the cataract surgical techniques commonly used in developing countries. This technique usually results in a.
Manual small incision cataract surgery • 1. Manual Small Incision Cataract Surgery Manual Small Incision Cataract Surgery A novel strategy for cataract removal This material is based on the experience of: Ravi Thomas, M.D. Prashant Garg, M.D. Prasad Eye Institute Hyderabad, India Edited by: Eugene M.
Helveston, M.D. Hunter Cherwek, M.D.
Technical Support: Lynda M. Smallwood Artist: Sharon TealIntroductionCataract surgery has undergone significant changes beginning with theabandonment of intracapsular surgery, and continuing with the advent ofintraocular lenses, and continuing variations in extracapsular lens removal.Extracapsular cataract surgery employing a 10 mm incision at the limbus andrequiring wound closure with sutures is considered a 'fall back' technique thatis easier to perform but has limitations. Phacoemulsification is used by mostsurgeons in developed countries and enables the most elegant surgery but ata high cost. A third technique, manual small incision cataract surgery(MSICS), retains most of the advantages of 'phaco' but can be delivered atlower cost and is more readily applied in high volume programs. In thefollowing, 'Phaco' and manual small incision cataract surgery are • compared and then a step-by-step description of the MSICS is presented.The goal of modern cataract surgery: • Rapid patient mobilization • Minimal induced astigmatism • Early visual rehabilitationTwo techniques which meet these criteria:1. Phacoemulsification Pro • 2.8-3.5 mm incision - sutureless • can implant foldable lens • fast - can be done + 10 minutes Con • difficult with hard nucleus • difficult with hypermature cataract • expensive, high maintenance equipment required • expensive disposables required • many countries do not do foldable lenses even with phaco; would seem a waste to do surgery with 3 mm and then enlarge to 6 mm2.
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