Study of manual small incision cataract surgery (MSICS) for ideal size of central curvilinear capsulorhexis(CCC): 6mm or larger

• Author Details:   
• Vasudha Damle
• Rahul Agarwal

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In India MSICS Is still preferred technique in volume surgery institutes. Now whether MSICS is done as a learning step to phacoemulsification, due to unavailability of machine or due to lack of skill; advantages of Cental Curvilinear Capsulorhexis cannot be ignored though visual outcome may be the same. It not only acts as a lifeline in PC rent but it secures the IOL in the bag also. But simultaneously delivery of the nucleus through CCC is bit tricky. So it’s not only mandatory for phacoemulsification, for MSICS surgeon it makes the learning curve easier and uplifts the quality of MSICS surgery too. In this study comparative analysis has been done between two groups where in group A CCC in the range of 5.5 mm to 6mm with radial cuts was made and in group B CCC more than 6mm(in the range of 6mm to 6.5mm)was made. It was found that in patients where CCC less than 6mm was made, delivery of nucleus was not smooth and problems like zonulolysis, PC rent, bag detachment were noticed after nucleus delivery. In cases where bigger CCC 6mm or more was made delivery of nucleus was easy and complications were less. So to conclude always aim for CCC more than 6 mm in MSICS. In bigger CCC even 6mm optic/12.5mm PMMA lens can be implanted in the bag without stretching and decentration.

Keywords: Central Curvilinear Capsulorhexis, Capsulotomy, Decentration, PCO, Zonulolysis