© 2011 Wichtig Editore - ISSN 1120-6721 Eur J Ophthalmol ( 2011 ; : 6) 748-753 21 748 DOI: 10.5301/EJO.2011.6521 INTRODUCTION Cataract is the major cause of avoidable blindness in In- dia and the developing world (1, 2). Manual small incision cataract surgery (SICS) has been popularized as an effec- tive, economical alternative to phacoemulsification in the developing world to tackle cataracts (3, 4). The surgical re- sults and rate of complications of SICS are comparable to phacoemulsification (3, 5). Various techniques have been Safety and efficacy of temporal manual small incision cataract surgery in India Swati V. Zawar 1 , Parikshit Gogate 2,3 1 Tulsi Eye Hospital, Nashik - India 2 Dr. Gogate’s Eye Clinic, Pune - India 3 Lions NAB Eye Hospital, Miraj - India PURPOSE. To assess safety and efficacy of temporal manual small incision cataract surgery (SICS) in context to visual outcome, astigmatism, and complications. METHODS. This involved sclerocorneal tunnel, capsulotomy, and hydrodissection. The incision was made with number 11 disposable surgical blade (costing Indian Rs. 2.50, $0.05). Nucleus extraction was done by phaco-sandwich method with the help of vectis and dialer. Posterior chamber intraocular lens implantation was done according to biometric findings. A record of intraoperative and postope- rative complications was made. The final postoperative assessment of astigmatism was done with spectacle correction on the 45th day as per the refraction findings. RESULTS. Two thousand eyes were operated by temporal, manual small incision sutureless technique. Uncorrected visual acuity was >6/18 in 1636 (81.7%) patients on the first postoperative day, in 1652 (82.6%) patients at 2 weeks, and in 1732 (88.6%) patients at 6 weeks. Best-corrected visual acuity (BCVA) >6/18 was achieved in 1868 (93.4%) patients at 6 weeks, with 46 (2.3%) having BCVA <6/60, 24 (1.2%) of whom had preexisting retinal pathology. At 6 weeks, 1876 (93.8%) eyes had with-the-rule and 134 (6.2%) against-the-rule astigmatism (mean 0.7±1.25 D). Iris prolapse was noted in 3 (0.15%), wound leak in 3 (0.15%), and transient corneal edema in 136 (6.8%) eyes. Average surgery time was 6 minutes. CONCLUSIONS. Temporal SICS with number 11 disposable surgical blade and nucleus delivery by phaco- sandwich method gave excellent outcome with minimal astigmatism and low complication rate at economic cost. KEY WORDS. Astigmatism, Phaco-sandwich, Small incision cataract surgery, Temporal incision, Visual outcome Accepted: February 21, 2011 ORIGINAL ARTICLE developed to achieve reasonable success in SICS such as phacofracture (6), phaco-sandwich (7, 8), visco-expression of nucleus (9), and Blumenthal technique (10). Patients with cataract in developing countries often have bilateral mature cataract with dense, hard nuclei and they often have preexisting ocular comorbidity like corneal opa- city, iridocyclitis, and glaucoma (11). Their need is early wound stabilization, rapid visual recovery, and less astig- matism. Most methods of manual SICS rely on the superior