Introduction

Cataract has been documented to be the most significant cause of bilateral blindness in India where vision <20/200 in the better eye on presentation is defined as blindness. In India, cataract has been reported to be responsible for 50-80% of the bilaterally blind in the country. The first surgical procedure for cataract was displacement of lens into the vitreous cavity introduced by Susruta (600BC). Daviel J (1753) described planned extracapsular cataract surgery. To overcome the pitfalls of conventional ECCE Kelman CD (1967) introduced the technique of phacoemulsification for removing the cataractous lens. The advantages of phacoemulsification are that it can be performed under local anaesthesia, minimal post op complications, early visual rehabilitation and postoperative astigmatism is comparatively less. But it requires more skill and sophisticated equipments which are quite expensive and in an economically weaker country like India, the method needs to be cheap and effective. in order to obtain the advantages of a self sealing sutureless incision at alower cost, ophthalmologist developed another technique called Manual small incision cataract surgery. The final visual outcome has been observed to be similar after MSICS and phacoemulsification. Phacoemulsification with standard 2.8mm incision achieves minimal post op astigmatism but a foldable IOL is a prerequisite for this procedure. One more modification in standard phacoemulsification procedure is to enlarge the incision size to 5.5mm & implant 5.25mm PMMA PCIOL so that on one hand the advantages of phacoemulsification can be retained and on the other hand cost factor is also reduced.

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Dr Sakshi Sahni

GMC Jammu, India