Material and Method: The present study was retrospective and non-comparative. The advanced (mature and brunescent) cataract patients were operated with a new surgical technique of manual small incision cataract surgery (MSICS: A technique). Data was collected from medical records between October 2011 and September 2013 at Prasat Neurological Institute. The records of 30 advanced cataract eyes that received surgery were reviewed. The clinical data of visual acuity (VA), pre- and post-operative astigmatism, intraoperative, and post-operative complications, and follow-up from day 1, 5, 28, and 90 post-operative days were collected.

Results: Thirty eyes of 25 patients were operated with MSICS (A technique). Post-operative BCVA results were 20/20 or better in 12 eyes (40%), 20/25 to 20/70 in 16 eyes (53.3%), 20/80 to 20/160 in one eye (3.3%), and 20/200 or worse in one eye (3.3%). The different astigmatism was (pre- minus post-operative astigmatism) 0.58±1.12 diopters, range -1.75 to 3.25, 95% CI 0.16-0.99 (p<0.01). No major surgical complication was found.

Conclusion: The new MSICS (A technique) can be recommended as a safe alternative cataract surgery for mature and brunescent cataract disease in developing countries.

Keywords: MSICS, Advanced cataract, Mature cataract, Brunescent cataract, A technique