3035: Optimizing the incision in MSICS – scleral incision
Optimizing incision architecture in Manual Shelved Incision Cataract Surgery (MSICS) is paramount, and keeping the tunnel primarily within scleral tissue offers a distinct biological advantage. Because the sclera is highly vascularized compared to the avascular clear cornea, a predominantly scleral tunnel promotes robust long-term wound healing, structural stability, and a reduced risk of late wound leakage or astigmatic decay. By crafting a deep, uniform scleral shelf with a well-defined internal corneal valve, this technique achieves an exceptional watertight seal without requiring sutures, even after expressing a large, dense nucleus. Watch the video to see how precise scleral tunnel construction and immaculate tissue planes optimize both intraoperative chamber stability and post-operative structural integrity. How do you balance scleral depth versus tunnel length to ensure maximum wound strength and rapid healing in your MSICS cases? Please comment your thoughts below.
