Manual SICS with nucleus bisection

SICS is small incision cataract surgery, and it refers to a method of manual expression of the nucleus through a carefully constructed corneo-scleral incision. It is an advancement over the older technique of manual ECCE (extra-capsular cataract extraction) which did not use an advanced incision and therefore required multiple sutures for closure.

The incision for most SICS cases is about 8 mm wide at the sclera but funnel shaped (trapezoidal) so that it is about 11 mm wide at the corneal entrance. In this video, guest surgeon Dr. M.S. Ravindra from Bangalore, India uses a smaller incision of just 6 mm wide at the sclera and about 7-8 mm wide at the corneal entrance. He is able to use the smaller incision because he manually bisects the nucleus into two halves and then removes each half separately.

At the end of the case fibrin glue is used to seal the incision as well as close the conjunctiva. The case is shown in its entirety and is less than 5 minutes. The patient achieved a very rapid recovery of good vision after surgery. This is a great technique and can be done without the use of a phaco machine. I already teach SICS to our UCLA ophthalmology residents and I will also start teaching the nucleus bisection technique.

Click below to learn the manual SICS with nucleus bisection:

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