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Dennis S. C. Lam, MD, FRCOphth; Srinivas K. Rao, FRCS; Alex H. Fan, MRCSEd, MMed, Ophth; Nathan G. Congdon, MD, MPH; Victoria Wong, MMedSc, MRCS; Yingpeng Liu, MD; Philip T. H. Lam, FRCS, FRCOphth

Arch Ophthalmol. 2009;127(10):1284-1289.

Objectives  To describe a modified manual cataract extraction technique, sutureless large-incision manual cataract extraction (SLIMCE), and to report its clinical outcomes.

Methods  Case notes of 50 consecutive patients with cataract surgery performed using the SLIMCE technique were retrospectively reviewed. Clinical outcomes 3 months after surgery were analyzed, including postoperative uncorrected visual acuity, best-corrected visual acuity, intraoperative and postoperative complications, endothelial cell loss, and surgically induced astigmatism using the vector analysis method.

Results  At the 3-month follow-up, all 50 patients had postoperative best-corrected visual acuity of at least 20/60, and 37 patients (74%) had visual acuity of at least 20/30. Uncorrected visual acuity was at least 20/68 in 28 patients (56%) and was between 20/80 and 20/200 in 22 patients (44%). No significant intraoperative complications were encountered, and sutureless wounds were achieved in all but 2 patients. At the 3-month follow-up, endothelial cell loss was 3.9%, and the mean surgically induced astigmatism was 0.69 diopter.

Conclusions  SLIMCE is a safe and effective manual cataract extraction technique with low rates of surgically induced astigmatism and endothelial cell loss. In view of its low cost, SLIMCE may have a potential role in reducing cataract blindness in developing countries.

Author Affiliations: Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Eye Hospital, Kowloon (Drs D. Lam, Rao, Fan, Congdon, Wong, and P. Lam) and Joint Shantou International Eye Centre of Shantou University, The Chinese University of Hong Kong, Shantou, China (Drs D. Lam, Rao, Congdon, and Liu).

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