02/02/2025
Small Incision Cataract Surgery (SICS) is not an outdated technique. While phacoemulsification is the preferred method in high-income countries due to its small incision and rapid recovery, SICS remains highly relevant and widely used in many parts of the world, especially in developing countries.
Why SICS is Still a Valuable Technique
✅ Cost-Effective & Accessible – SICS does not require expensive phaco machines, making it the best option for high-volume cataract surgery in low-resource settings.
✅ Better for Advanced Cataracts – Many patients in developing countries present with mature or hypermature cataracts, which are difficult to remove with phaco but easier with SICS.
✅ Quick & Efficient – A skilled surgeon can perform SICS in 10-15 minutes, making it ideal for large-scale cataract camps and government eye care programs.
✅ Good Visual Outcomes – Studies show that SICS provides comparable visual acuity to phaco, especially when performed by experienced surgeons.
✅ Less Dependence on Technology – SICS does not require electricity or high-end equipment, making it suitable for rural areas and outreach settings.
SICS vs. Phacoemulsification
Feature SICS Phacoemulsification
Incision Size 5–7mm (self-sealing) 2.2–2.8mm
Cost Low High
Suitability for Hard Cataracts Excellent Challenging
Astigmatism Slightly higher Minimal
Need for Machine No Yes
Post-op Recovery Slightly longer Faster
Conclusion
SICS is not outdated, but rather a complementary technique to phaco. In many developing countries, it remains the preferred method for treating cataracts efficiently and affordably. Many national eye care programs, including VISION 2020, continue to promote SICS for high-volume cataract surgery.
