SICS or manual small incision cataract surgery is a procedure reserved for ultra dense or difficult cataracts in which phacoemulsification is not possible. Though performed very rarely, it is a very useful tool in a cataract surgeon’s armamentarium, as it is atraumatic and endothelial safe. The recovery following surgery is relatively hassle free and the procedure has an excellent track safety record, with billions of the same, being performed world wide.