In the course of the last 30 years, the technique of cataract surgery has greatly improved. Beginning with an incision size of 12mm for intracapsular cataract extraction (ICCE) down to 2.2–2.8mm in modern phacoemulsification; however, phacoemulsification cannot be used as a routine intervention for cataract surgery in many low-income and underdeveloped countries due to the high costs and elaborate technique. In contrast, manual small incision cataract surgery (MSICS), a combination of extracapsular
cataract extraction (ECCE) and small incision cataract surgery (SICS) has nearly the same advantages but is substantially more widely applicable, less time consuming, has a shorter learning curve and in particular much lower costs. This article presents the problems of cataract surgery in low-income countries and describes the MSICS technique.

Cataract · Cataract surgery in Sub-Saharan Africa · Technique of manual small incision cataract surgery · Vision 2020 · Human resources for eye health (HREH)