Small incision cataract surgery (SICS) with nucleus fragmentation: A narrative review

• Author Details:   
• Syed Ali Nasar Waris
• Nandhakumar Chinnaiyan
• Mohan Ram Kumar
• R Deborah Rinita
• Pratistha Rath
• Rubina Huda ^*

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Cataract remains the leading cause of blindness globally, with a significant impact on aging populations. Small incision cataract surgery (SICS) with nucleus fragmentation has emerged as a viable alternative to phacoemulsification, particularly in resource-limited settings. This narrative review examines the evolution of cataract surgery techniques, with a focus on SICS and its integration of nucleus fragmentation methods. The review highlights the visual outcomes of SICS, particularly in cases of dense cataracts, and underscores its cost-effectiveness and accessibility in developing countries. Various nucleus fragmentation techniques, including manual, mechanical, and enzymatic approaches, are discussed, along with their respective advantages and challenges. The safety profile of SICS is also reviewed, showing low complication rates and favourable postoperative recovery. The review concludes with recommendations for future research and practice, emphasizing the need for enhanced surgical training, innovation in fragmentation techniques, and continued evaluation of long-term patient outcomes. SICS with nucleus fragmentation stands as a critical tool in reducing cataract-related blindness, especially in underserved regions.

Keywords: SICS, Nucleus fragmentation, Visual outcome.