Support from ESCRS Boosts Cataract Care

In November 2025, I participated, as an active member of ESCRS, in a vital educational initiative focused on teaching manual small-incision cataract surgery (MSICS). The mission took me to the University of Cape Town’s Community Eye Health Institute (UCT-CEHI) in South Africa, followed by clinical work in Eswatini at the Good Shepherd Hospital and the Grace Vision Clinic in Siteki.

The primary objectives of my mission were clear: to instruct young African doctors in this highly effective surgical method and to immerse myself in the clinical environment of Siteki, Eswatini. The instructional goal was successfully achieved through an intensive programme led by four expert tutors who provided three full days of hands-on wet lab training in MSICS. This effort culminated in the successful certification of six young surgeons, significantly boosting regional capacity.

I discovered the call for interest for this training programme via the ESCRS website. The programme follows a well-established curriculum, with the initial two days providing trainees with a comprehensive theoretical and practical introduction to every step of the MSICS procedure. Educational support materials included a specialised booklet and detailed PowerPoint presentations. This was followed by extensive hands-on practice of all surgical steps using sophisticated cataract eye models.

The course concluded on the third day with advanced training modules focused specifically on complication management, using both eye models and sessions on the advanced EyeSi Simulator. A key component of the assessment was a self-evaluation performed by trainees using the Sim-OSSCAR (SICS Ophthalmic Simulated Surgical Competency Assessment Rubric), a tool validated against the rigorous International Council of Ophthalmology (ICO) standards for evaluating competency.

During the second week of my trip, I took a two-hour flight to the Kingdom of Eswatini, an independent nation bordered mostly by South Africa. During my time there, I performed several surgical operations at the Good Shepherd Catholic Hospital in Siteki. I also actively participated in numerous clinical consultations at the Grace Vision Clinic, a specialised eye care centre situated in the same region.

In South Africa and Eswatini, the treatment of cataracts—the single leading cause of blindness—is severely hindered by systemic issues, including a critical shortage of surgeons and essential hospital resources. This results in multi-year wait¬ing lists for necessary surgeries and significant geographic disparities in care access. To address these systemic gaps and alleviate the frustration of junior doctors lacking sufficient hands-on experience, the UCT Community Eye Health Institute (CEHI), with vital financial and material support from the ESCRS, organises these annual MSICS courses.

This highly-rated programme provides essential surgical training in a cost-effective, high-quality technique that is ideal for treating hard cataracts. It simultaneously fosters a valuable and reciprocal exchange of knowledge between local practitioners and international surgeons.

Special thanks are due to Dr Mark Wevill, a surgical trainer at the UCT-CEHI and a member of the ESCRS Charity Committee, who provides financial and material support to UCT-CEHI. Additionally, immense gratitude is extended to Dr Jonathan Pons for his role as a surgical trainer at the UCT-CEHI and for his outstanding hospitality in Siteki, Eswatini. I was profoundly impressed by the great clinical and teaching work Dr Pons has provided consistently for many years.

In conclusion, I highly recommend this MSICS course to all ESCRS members who are cataract surgeons, as it is beneficial for those both with and without previous experience in the technique.

Vasileios Petousis is a consultant ophthalmologist in vitreoretinal and cataract surgery at the Centre Ophtalmologique Luxembourg. vpetousis@outlook.com