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   Table of Contents      
Year : 2015  |  Volume : 63  |  Issue : 10  |  Page : 804

Reply to comment: Conventional manual small-incision cataract surgery

1 Department of Ophthalmology, the First People's Hospital of Yunnan Province, Nanchang, Jiangxi, China
2 Jiangxi Eye Center, Jiangxi Provincial People's Hospital, Nanchang, Jiangxi, China

Date of Web Publication10-Dec-2015

Correspondence Address:
Dr. Pinghong Lai
Jiangxi Eye Center, Jiangxi provincial People's Hospital, 92 Aiguo Road, Nanchang, Jiangxi
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0301-4738.171526

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How to cite this article:
Yang J, Lai P. Reply to comment: Conventional manual small-incision cataract surgery. Indian J Ophthalmol 2015;63:804

How to cite this URL:
Yang J, Lai P. Reply to comment: Conventional manual small-incision cataract surgery. Indian J Ophthalmol [serial online] 2015 [cited 2023 Apr 1];63:804. Available from: https://journals.lww.com/ijo/pages/default.aspx/text.asp?2015/63/10/804/171526

Dear Sir,

We would like to thank Chew and Tan [1] for their comments on our article, "manual cataract extraction via a subconjunctival limbus oblique incision for mature cataracts." [2]

Though both conventional manual small-incision cataract surgery (MSICS) and subconjunctival oblique limbus incision (SCOLI) are demonstrated to be safe and effective techniques for treatment of cataract patients, [2],[3],[4] SCOLI may be the preferred technique in the setting of high daily volumes.

First, conventional MSICS sometimes meets difficult in delivering a large, hard nucleus through the long tunnel (3-3.5 mm) without fragmentation. [5],[6] The shorter tunnel length (1.5 mm) in SCOLI permits easy delivery of a large nucleus.

Second, less surgical trauma to conjunctiva/sclera and free of a rectus bridle suture contribute to the less-invasive characteristics and bring the trend toward topical anesthesia in SCOLI, thus minimizing the risks related to local anesthesia and reducing the preoperative preparation time.

Third, the SCOLI technique is free of creating a conjunctiva flap, hence the following Westfield cautery and the conjunctiva opposing at the end of the surgery. These merits help to save a lot of surgery time.

In addition, flexibility is another advantage of SCOLI over the conventional MSICS. This limbal incision can be easily converted to conventional extracapsular cataract extraction (ECCE) in necessary. Meanwhile, we can easily convert phacoemulsification into SCLOI. Therefore, SCOLI is a good option for a surgeon who is in the transition from ECCE to phacoemulsification.

For these reasons, we believe that SCLOI is the more appropriate technique for addressing the large and growing backlog of blinding cataracts in the developing world.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

  References Top

Chew MC, Tan CS. Conventional manual small-incision cataract surgery. Indian J Ophthalmol 2015;63:293-4.  Back to cited text no. 1
[PUBMED]  Medknow Journal  
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. 2
[PUBMED]  Medknow Journal  
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
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. 4
Deng JW, Yang YT, Zeng Y, Tang ZM, Liu XJ, Fu XY. Two-hook technique for nucleus extraction in manual sutureless extracapsular cataract extraction. J Cataract Refract Surg 2013;39:497-500.  Back to cited text no. 5
Zeng Y, Deng JW, Gao JH. A novel nucleus extraction technique using a vectis in sutureless, manual, small-incision cataract surgery. Nepal J Ophthalmol 2014;6:140-4.  Back to cited text no. 6


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