This document discusses the evolution and advances in Manual Small Incision Cataract Surgery (MSICS). It notes that while phacoemulsification is preferred due to benefits like outpatient surgery and rapid recovery, MSICS remains important as it is more cost effective and better for hard cataracts. The document outlines some technical advances in MSICS, including smaller incisions, enhanced anesthesia techniques, and modifications to induce multifocality and control astigmatism. It discusses the role of the International Society of Manual Small Incision Cataract Surgeons in popularizing MSICS globally, with India as a leader, and notes the success of international conferences on MSICS.

1. Manual small Incision Cataract
Surgery (MSICS) Today
NSD Raju

2. No Financial Interest

3. Introduction
• MSICS Has Come of age
• MSICS Vs PHACO

4. Phaco as Choice Procedure
for cataract surgery
• Topical anesthesia
• Outpatient Surgery
• No injection no patch
• Back to work in couple of days
• Rapid Visual rehabilitation

5. Evolution of MSICS
• Phaco an expensive procedure not cost effective
• Outcome in hard cataract often unsatisfactory
• Long learning period
• High volume surgery as in camps not practical
• Surgery takes more time as against MSICS

6. Evolution of MSICS
• Standard technique
• Regular topical insufficient
• Mostly Peribulbar or modified peribulbar
• Caruncular
• Local infiltration
• Subtenon infusion

8. Incision

9. Sheets Glide

11. IOL implantation

12. • SOME Advances and modiications in MSICS technique

13. Shaping frown Incision

14. Blumenthal A C Maintainer

15. Temporal Incision

16. Other Advances in MSICS
• Topical MSICS
• Enhanced topical anesthesia

17. Paracaine - soaked Merocel Pledget

18. No Stitch no Patch MSICS

19. Recent Advances continued
• Smaller Incisions 3- 4 mm
• Phaco fracture including intra tunnel fracturing
• Control and management of astigmatism
• Inducing multifocality
• Research work is already going on

20. International Society of Manual Small Incision
Cataract Surgeons
• India as a leader in MSICS
• Played a decisive role in popularizing MSICS Globally
• Established in 2005
• MICS constitute 70% of Cataract surgery in our country

21. ISMSICS International Conferences
• Indonesia
• Philippines
• Egypt
• China
• Sweden
• ISMSICS collaborated with Prevention of Blindness Program in India

22. First World Conference on MSICS at Pune
2015
• This World Conference showed India to be the power house of MSICS
• More than 15 countries participated in the Conference
• The Conference was a great success

23. • Conclusion

24. Thank You