• Mir Zaman
  • Ashfaq Ali Shah
  • Mahfooz Hussain
  • Tariq Farooq Babar
  • Muhammad Tariq Khan Marwat
  • Sanaullah Dawar


Background: Cataract surgery is constantly evolving. Purpose of this study was two folds: toestimate visual outcome and evaluate safety and efficacy of sutureless manual extra-capsular cataractextraction. Methods: This was a prospective, interventional case series, using sutureless manualextra capsular cataract surgery technique from June 2004 to January 2007 at Khyber Institute ofOphthalmic Medical Sciences, Hayatabad Medical Complex Peshawar. Patients included in thestudy were those having operable cataracts. All those having corneal co-morbidities extensiveenough to block visualisation of posterior segment details, chronic adenexal diseases, long standingglaucoma, advanced diabetic eye disease and retinal detachment evident on B-Scan ultrasonographywere excluded from the study. After thorough examination and investigation all the patients wereoperated upon by a single experienced surgeon using the same technique. Their visual outcome wasanalysed. The patients were followed for a period of six weeks. Results: A total of 1500 cataractsurgeries were carried out, of which 1211 (80.74%) patients completed six weeks of follow up.Seven hundred and fifty seven (62.51%) had an uncorrected good visual acuity (6/6–6/18) on 1stpost-op day, 1131 patients (93.40%) had an uncorrected visual acuity of 6/6–6/18 on 6th week followup. Mean surgically induced astigmatism at 6 weeks was 0.3 dioptres. Conclusion: Suturelessmanual extra capsular cataract surgery is a safe and effective technique. It offers faster woundhealing and quick rehabilitation of cataract patients at any level of community eye care setting.Keywords: Sutureless cataract extraction, visual outcome, astigmatism.


Shah SP, Dineen B, Jadoon Z, Bourne R, Khan MA, Johnson

GJ et al. Lens opacities in adults in Pakistan: Prevalence and

risk factors. Ophthalmic Epidemiol 2007;14;06, 381–9.

Government of Pakistan, Ministry of economic affairs

statistics division. Population census organization 1998.

Availabe from: http://statpak.gov.pk

Jadoon MZ, Dineen B, Bourne RA, Shah SP, Khan MA,

Johnson GJ et al. Prevalence of blindness and visual

impairment in Pakistan: The Pakistan National blindness and

visual impairment survey. Invest Ophthalmol Vis Sci


Dineen B, Bourne RR, Jadoon Z, Shah SP, Khan MA, Foster

A et al. Causes of blindness and visual impairment in

Pakistan. Br J Ophthalmol 2007;91:1005–10.

J Ayub Med Coll Abbottabad 2009;21(1)


El Maghraby A, Anwar M, EL-Sayyad F. Effect of incision

size on early post operative visual rehabilitation after cataract

surgery and intra-ocular lens implantation. J Cataract Refract

Surg 1993;19:494–8.

Zaman M, Iqbal S, Khan MY, Khan MT, Jadoon MZ,

Qureshi MB et al. Manual small incision cataract surgery.

Review of first 500 cases operated in Microsurgical training

center. Pak J Ophthalmol 2006;22(1):14–22.

Ruit S, Paudyal G, Gurung R, Tabin G, Moran D, Brian G.

An innovation in developing world cataract surgery:

sutureless extracapsular cataract extraction with intraocular

lens implantation. Clin Experiment Ophthalmol


Muralikrishnan R, Venkatesh R, Manohar BB, Prajna NV. A

comparison of the effectiveness and cost effectiveness of

three different methods of cataract extraction in relation to

the magnitude of postoperative astigmatism. Asia Pacific J

Ophthalmol 2003;15:5–12.

Hennig A, Kumar J, Yorston D, Foster A. Sutureless cataract

surgery with nuclear extraction. Outcome of a prospective

study in Nepal. Br J Ophthalmol 2003;87:266–70.

Lewis A, Congdon N, Munoz B. Cataract surgery and

subtypes in a defined older population. The SEECAT project.

Br J Ophthalmol. 2004;88:1512–7.

Desai P, Reidy A, Minassian DC. Profile of patients

presenting for cataract surgery in UK: Nnational data

collection. Br J Ophthalmol 1999;83:893–6.

Yorston D, Gichuhi S, Wood M, Foster A, Does prospective

monitoring improve cataract surgery outcomes in Africa. Br J

Ophthalmol (on line) 86(5):543–7.

John ME, Noblitt RL, Boleyn KL. Effect of superficial and

deep scleral pocket incision on the incidence of hyphaema. J

Cataract Refract Surg 1992;18:495–9.

Gogate PM, Deshpande M, Wormald RP, Deshpande RD,

Kulkarni SR. Extra capsular cataract surgery compared with

MSICS in community eye care setting in Western India, a

randomized control trial. Br J Ophthalmol 2003;87:667–72.

Pratab VP. Bali T. Non-phaco sutureless cataract surgery an

easy technique using “fishhook”. AIOC Proceedings 2002.


Guzek JP, Ching A. Small incision manual extra capsular

cataract surgery in Ghana, West Africa. J Cataract Refract

Surg 2003;29:57–64.

Burganshky Z, Isakov I, Aviemer H, Bartov E. Minimal

astigmatism after sutureless planned extra capsular cataract

extraction. J Cataract Refract Surg 2002;28:499–503.

Kimura M, Nagata M. Extra capsular cataract extraction with

a sutureless incision for dense cataracts. J Cataract Refract

Surg 1999;25:1275–9.



Most read articles by the same author(s)