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   Table of Contents      
LETTER TO THE EDITOR
Year : 2015  |  Volume : 63  |  Issue : 3  |  Page : 293-294

Conventional manual small-incision cataract surgery


1 Department of Ophthalmology, National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore
2 Department of Ophthalmology, National Healthcare Group Eye Institute, Tan Tock Seng Hospital; Fundus Image Reading Center, National Healthcare Group Eye Institute, Singapore

Date of Web Publication13-May-2015

Correspondence Address:
Dr. Colin S Tan
National Healthcare Group Eye Institute, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng
Singapore
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0301-4738.156973

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How to cite this article:
Chew MC, Tan CS. Conventional manual small-incision cataract surgery. Indian J Ophthalmol 2015;63:293-4

How to cite this URL:
Chew MC, Tan CS. Conventional manual small-incision cataract surgery. Indian J Ophthalmol [serial online] 2015 [cited 2019 Nov 17];63:293-4. Available from: http://www.ijo.in/text.asp?2015/63/3/293/156973

Sir,

We read with interest the article by Yang et al. [1] describing good visual outcomes in manual cataract extraction via a subconjunctival limbus oblique incision (SCOLI) for mature cataracts. Although the authors' results are impressive, we would like to highlight that conventional manual small-incision cataract surgery (MSICS) can also produce very good visual and refractive outcomes.

Several studies have demonstrated that MSICS is safe and effective, even in advanced or complicated cataracts. Venkatesh et al.[2] described excellent visual outcomes of MSICS performed on a group of patients with brown and brunescent cataracts, with 97.1% achieving visual acuity (VA) of 6/18 or better with low complication rates. Another paper, also reported excellent outcomes in white cataracts, [3] with 98.2% achieving corrected distance VA of 6/18 or better. MSICS has also been shown to be safe in patients with phacolytic glaucoma, [4] demonstrating good visual outcomes with 87.9% of patients achieving good visual outcomes of 20/60 or better, while intraocular pressure was controlled without the need for long-term anti-glaucoma medications.

Although the authors reported SCOLI induces less iatrogenic astigmatism due to its supero-oblique incision, [1] Ruit et al. [5] had demonstrated that conventional MSICS can similarly reduce induced astigmatism by adopting a temporal approach. A recent Cochrane review [6] further suggests that conventional MSICS results in less surgically-induced astigmatism compared to extra-capsular cataract extraction.

In summary, we congratulate the authors in promoting and teaching alternative techniques of cataract surgery that are safe, efficacious, and cost-effective. In conjunction with the International Agency for the Prevention of Blindness and the World Health Organization Programme for Blindness and Deafness, this is part of a strategy to reduce cataract blindness globally. We feel that it is important for clinicians to consider the option of MSICS as part of their surgical repertoire.

 
  References Top

1.
Yang J, Lai P, Wu D, Long Z. Manual cataract extraction via a subconjunctival limbus oblique incision for mature cataracts. Indian J Ophthalmol 2014;62:274-8.  Back to cited text no. 1
[PUBMED]  Medknow Journal  
2.
Venkatesh R, Tan CS, Singh GP, Veena K, Krishnan KT, Ravindran RD. Safety and efficacy of manual small incision cataract surgery for brunescent and black cataracts. Eye (Lond) 2009;23:1155-7.  Back to cited text no. 2
    
3.
Venkatesh R, Tan CS, Sengupta S, Ravindran RD, Krishnan KT, Chang DF. Phacoemulsification versus manual small-incision cataract surgery for white cataract. J Cataract Refract Surg 2010;36:1849-54.  Back to cited text no. 3
    
4.
Venkatesh R, Tan CS, Kumar TT, Ravindran RD. Safety and efficacy of manual small incision cataract surgery for phacolytic glaucoma. Br J Ophthalmol 2007;91:279-81.  Back to cited text no. 4
    
5.
Ruit S, Tabin G, Chang D, Bajracharya L, Kline DC, Richheimer W, et al. A prospective randomized clinical trial of phacoemulsification vs manual sutureless small-incision extracapsular cataract surgery in Nepal. Am J Ophthalmol 2007;143:32-38.  Back to cited text no. 5
    
6.
Ang M, Evans JR, Mehta JS. Manual small incision cataract surgery (MSICS) with posterior chamber intraocular lens versus extracapsular cataract extraction (ECCE) with posterior chamber intraocular lens for age-related cataract. Cochrane Database Syst Rev 2012;4:CD008811.  Back to cited text no. 6
    




 

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