3036: resident’s first MSICS case
Learning Manual Shelved Incision Cataract Surgery (MSICS) is a essential milestone in surgical training, and residents deserve great credit for tackling their first cases. While the effort is commendable, critical analysis of the wound construction reveals that the tunneling extended too far into the anterior corneal stroma and produced an irregular, non-uniform tissue plane. Tunneling excessively into the avascular cornea rather than keeping the primary architecture within the vascular sclera compromises the self-sealing mechanism, increases post-operative astigmatism, and prolongs wound healing. Maintaining a steady blade angle at a uniform depth within the sclera creates a smooth, well-shelved flap that yields predictable structural integrity and a watertight closure. Watch the video to see this inaugural case, analyze the incision morphology, and review the adjustments needed for a better scleral tunnel. What key pointers do you give trainees on their first MSICS case to ensure they maintain the correct depth and avoid extending too far into clear cornea? Please comment your pearls below.
