An effective cataract surgeon in the developing world is one who is doing high volume, low cost and low complication surgery. For many of these effective cataract surgeons, the operation of choice is now sutureless non-phaco cataract extraction, and others are changing to this technique. The purpose of this article is to try to describe the principles of this technique (there are several different ways of doing it) , its advantages and disadvantages and how to avoid mistakes and complications.

Sutureless non-phaco cataract surgery requires three separate and different steps:

• The incision is made so as to be self-sealing and as free from resulting astigmatism as possible. At the same time, it needs to be large enough to allow the entire lens nucleus to be removed in one piece.
• The nucleus is then mobilised inside the eye, and inside the lens, to enable it to be removed.
• The nucleus is then removed without damaging either the cornea or the posterior lens capsule.