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Manual small incision cataract surgery (MSICS) is an evolution of extracapsular cataract extraction (ECCE); the lens is removed from the eye through a self-sealing scleral tunnel wound. A well-constructed scleral tunnel is held closed by internal pressure, is watertight, and does not require suturing.
Cataract surgery is the most common application of lens removal surgery, and is usually associated with lens replacement. It is used to remove the natural lens of the eye when it has developed a cataract, a cloudy area in the lens that causes visual impairment. [4] [10] Cataracts usually develop slowly and can affect one or both eyes. [4]
Refractive surgery is an optional eye surgery used to improve the refractive state of the eye and decrease or eliminate dependency on glasses or contact lenses. This can include various methods of surgical remodeling of the cornea ( keratomileusis ), lens implantation or lens replacement.
This procedure minimises the incision size and reduces the recovery time and risk of surgery-induced astigmatism. It is best suited to relatively soft cataracts, where the ultrasonic energy required is moderate, and insertion of foldable intraocular prosthetic lenses, which take advantage of the small incision possible.
In 2009, Praputsorn Kosakarn described a method for manual fragmentation of the lens, called "double-nylon loop", which consists in splitting the lens into three pieces for extraction, allowing a smaller, sutureless incision of 4.0 to 5.0 mm (0.16 to 0.20 in), and requires implantation of a foldable IOL. This technique uses less expensive ...
During CLEAR, the crystalline lens is extracted and an IOL replaces it in a process that is very similar to cataract surgery: both involve lens replacement, local anesthesia, last approximately 30 minutes, and require making a small incision in the eye for lens insertion. People recover from CLEAR surgery 1–7 days after the operation.
Limbal relaxing incisions (LRI) are a refractive surgical procedure to correct minor astigmatism in the eye. Incisions part way through the cornea are made at one side or at opposite edges of the cornea , following the curve of the iris , causing a slight flattening of the cornea in that area. [ 1 ]
The lens is expressed through a 10- to 12-mm incision which is closed with sutures at the end of surgery. ECCE is less frequently performed than phacoemulsification, but can be useful when dealing with very hard cataracts or other situations where emulsification is problematic. Manual small incision cataract surgery (MSICS) has evolved from ECCE.