Objectives: To find out the pattern of changes in intraocular pressure after manual small incision cataract surgery.

Methods: Consecutive patients (291 eyes of 291 patients) undergoing manual small incision cataract surgery were prospectively evaluated for change in IOP. Patients were further divided into two groups based on whether or not sutures were used to close the scleral tunnel. IOP was serially measured at day 1, 1st, 2nd, 4th, 6th, 8th and 12th week.

Results: The mean post operative IOP in eyes where sutures were not applied (12.59± 3.02 mmHg,

12.59±2.34mmHg, 12.54±2.19mmHg and 12.40±2.99 mm Hg at day1, 2week and 4weeks respectively) was lower than that where sutures were used to close the wound (15.57± 3.86mmHg, 14.05±2.52mmHg, 14.43±3.39mmHg at day1, 2weeks and 4 weeks respectively). There was a drop of IOP from the preoperative IOP in both suture (1.15±3.29mm Hg) and non suture (3.29±3.07mm Hg) group at 3 months of follow up.

Conclusion: There is a small drop of IOP following sutureless MSICS during long term follow up. Eyes where sutures are applied are more likely to have higher IOP than those without sutures at the initial post operative period.