Manual sutureless small incision cataract surgery / SCIS - A State of Sight #111

SICS is a great technique for cataract removal that can be performed safely, efficiently, and at a low cost. Geoff Tabin, MD from the University of Utah and the Himalayan Cataract Project is a strong proponent of this procedure and recently visited North Carolina to help teach it.

Watch this episode of A State of Sight with Isaac Porter, MD to learn more about manual sutureless small incision cataract surgery and how it can help relieve the global burden of cataract blindness.

Welcome to A State of Sight, I’m Isaac Porter and this is your update in ophthalmology and eye care from Raleigh. Today, I would like to explain manual sutureless small incision cataract surgery. Recently, Dr. Geoff Tabin, from the University of Utah and the Himalayan Cataract Project, was here in North Carolina at the University of North Carolina at Chapel Hill to teach this technique.

This eye surgery is a great way to remove cataracts, particularly ones that are very dense. It is also useful to remove cataracts in areas that don’t have access to the same level of medical care that we have in the United States. One of the great advantages is that this operation can be performed at a low cost without high technology equipment. I believe Dr. Tabin said they can remove cataracts for a total cost of $15 per eye including medications, equipment, lens implant, and disposables.

This technique is a different way to remove the cataracts because basically the entire cataract is removed all at once through a larger incision than we usually make for standard modern cataract surgery (phacoemulsification). The surgical approach is a little bit different to remove the cataracts this way. Instead of going through the clear cornea, an incision is started in the sclera, or the white part of the eye. Then this incision is enlarged, particularly internally to give access to the cataract. The surgeon can then open the lens capsule, loosen the lens to mobilize it, and remove the cloudy lens from the eye.

If there are any residual pieces of the cataract, they can be removed by manually aspirating them with fluid. Then the lens implant can be placed inside the eye. I think one of the greatest aspects about this technique, like the name says, is that it’s sutureless. There are no sutures generally needed in order to close this incision because of the way that the incision is created. Sutures can be expensive or difficult to access in certain parts of the world. Since this surgery can be done quickly, efficiently and safely with a self-sealing incision, this has been a good solution for global blindness due to cataracts.

If you look back to A State of Sight #75, we go into more details about the Himalayan Cataract Project and how it is helping to relieve the leading cause of blindness worldwide. If you have any questions about this technique or the global burden of cataracts, please post and we will be happy to answer them. Hopefully we will see you again next time on A State of Sight.