Please watch this fantastic surgical technique:
http://www.youtube.com/watch?v=f7b5fSPUgME
Developed by Dr. M. S. Ravindra from Bangalore, this is a temporal SICS being performed under local anesthesia.
The key-difference from a conventional temporal-SICS is the nucleus-fractis. The nucelus is divided into 2 smaller pieces before its extraction.This allows for a smaller tunnel length.
This can be done under topical anesthesia. The SIA (surgical-indued-astigmatism) will be zero (on ARK topography) and at the most 0.50 D. The technique does not need a Phaco-machine, but the results are very much similar. There is no pain, no need for intracameral xylocaine, no injections, and no need for bandaging the eye. The sclero-conreal tunnel is self-sealing if correctly fashioned (maintaining the tri-plane). The surgical time on average is 8 to 10 minutes. Extremely cost effective. The surgical set is small.