The main objective of modern cataract surgery is to achieve good unaided vision with early visual rehabilitation and minimal morbidity. One of the means of achieving this objective is by reducing the incision size. Over the years cataract surgery has evolved through progressively decreasing incision size from 10 to 12 mm of extracapsular cataract extraction (ECCE) to 4.0–6.0 mm of small incision cataract surgery (SICS) and to 2.2 mm of phacoemulsification. Though instant visual recovery with least astigmatism is possible with phacoemulsification, the cost of equipment and consumables has made this procedure less affordable to some surgeons and patients in many parts of the developing world. Good result comparable to what can be achieved with phacoemulsification is possible with manual small incision cataract surgery (MSICS). The crux of the surgery is nucleus management and this determines the size of the incision. This chapter deals with various methods of prolapsing the nucleus into the anterior chamber and extraction of the nucleus out of the eye with various types of instrumentation. The problems associated with each technique and the tips and pearls to overcome these problems are also discussed.
KeywordsAnterior Chamber Corneal Endothelium Anterior Capsule Superior Pole Extracapsular Cataract Extraction
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