3034: efficient MSICS Surgical Technique
Manual Shelved Incision Cataract Surgery (MSICS) is a nomenclature far more accurate than Manual Small Incision Cataract Surgery given that the incision is inherently wide, with its true defining characteristic being the self-sealing shelved sclerocorneal tunnel. It requires precise construction to ensure structural integrity and healing. In this video, the surgeon demonstrates an efficient tunneling technique where the crescent blade extends intentionally into the clear corneal stroma. Creating a generous, uniform corneal shelf allows the inner lip to act as a dynamic valve, maintaining a watertight seal under intraoperative intraocular pressure while providing the necessary clearance to manual express a dense, intact nucleus without corneal distortion. However perhaps long term healing would be better if the incision was more biased to the sclera which is a vascular tissue. Watch the video to analyze the precise blade angles and tissue planes needed to craft a this incision. What is your preferred tunnel geometry and internal entry width when performing MSICS? Please comment your thoughts below.
