Aim: To analyse the outcome of high volume cataract surgery in a developing country, community based, high volume eye hospital. Methods: In a non-comparative interventional case series, the authors reviewed the surgical outcomes of 593 patients with cataract operated upon by three high volume surgeons on six randomly selected days. There were 318 female (54%) and 275 male (46%) patients. Their mean age was 59.57 (SD 10.13) years. The majority of the patients underwent manual small incision cataract surgery (manual SICS). Extracapsular cataract extraction with posterior chamber intraocular lens (ECCE-PCIOL) and intracapsular cataract extraction (ICCE) were also done on a few patients as clinically indicated. Results: Best corrected visual acuity of >6/18 was achieved in 94% of the 520 patients who could be followed up on the 40th postoperative day (88% follow up rate). Intraoperative and immediate postoperative complications as defined by OCTET occurred in 11 (1.9%) and 75 (12.6%) patients, respectively. Average surgical time of 3.75 minutes per case (16-18 cases per hour) was achieved. Statistically significant risk factors for outcomes were found to be age .60, sex, and surgeon. Conclusion: High volume surgery using appropriate techniques and standardised protocols does not compromise quality of outcomes.O f the total estimated 38 million blind people in the world, 9-12 million are in India.1 2 Estimates report that 50%-80% of these people are blind because of cataract.1 2 In addition to the backlog, an additional 3.8 million become blind each year because of cataract.3 In 2000, 3.5 million cataract operations were performed, 4 but this remains insufficient to treat the backlog and the newly blind. In 1994, Natchiar et al suggested that productivity per individual surgeon/unit should be increased through a high volume, high quality cataract surgery approach to solve the problem of India's curable blind.5 More recently, the World Health Organization global initiatives have called for a dramatic increase in surgical volumes worldwide. 6 However, it is becoming more evident that outcomes of cataract surgery are not always good and this aspect of surgical services must be further examined.7 Some recent studies of high volume cataract surgery in India and Nepal report good results. [8][9][10][11][12][13][14] In order to investigate whether high volume surgeries can be performed routinely, without compromising quality, we retrospectively reviewed the results of 593 surgeries performed by three experienced surgeons, achieving surgical times of 3.75 minutes/case (16-18 cases/hour), utilising the technique of manual small incision cataract surgery (manual SICS). PATIENTS AND METHODSSurgeons consistently performing more than 80 surgeries per day in six operating hours at Aravind were defined as ''high volume surgeons.'' There were six such high volume surgeons during the period of analysis from April 2002-March 2003. From these six surgeons, three were randomly chosen using a lot method. There were 28 days (clusters) dur...

* BACKGROUND AND OBJECTIVE: To describe the use of small incision sutureless cataract surgery (SISCS) that permits high-volume, high-quality, and low-cost surgery. * PATIENTS AND METHODS: We compared the speed, safety, and visual results of 1 1 90 surgical techniques performed in a public eye camp in India. Intraocular lenses were received by 97% of patients (1154). Surgical techniques used were SISCS, phacoemulsification, and standard extracapsular cataract extraction (ECCE) technique. * RESULTS: Postoperatively, 60.0% attained uncorrected vision of 6/24 or better. There was little difference in visual results or complication rates among the three techniques. The most striking finding is the speed of SISCS, which enables experienced surgeons to perform the technique in 3.8 to 4.2 minutes. * CONCLUSION: We believe this surgical technique is of major importance especially in developing nations facing enormous surgical volumes and limited resources. [Ophthalmic Surg Lasers 2001;32:446-455]