Abstract:AIM: To report the short- and medium-term outcomes of sutureless large-incision manual cataract extraction using the Kongsap (SLIMCE-K) technique. METHODS: This prospective study included 73 eyes of 73 patients who underwent cataract surgery performed by using the SLIMCE-K technique. The postoperative visual acuity, intraoperative and postoperative complications, and endothelial cell loss were evaluated. A follow-up visit, at least 6 months after the surgery, was included in the study. RESULTS: All patients had improved visual acuity after surgery. Uncorrected visual acuity (UCVA) was 6/18 or better in 55 eyes (75.3%) at 1 week postoperatively and in 64 eyes (87.6%) at 6 weeks postoperatively (P=0.09). The best corrected visual acuity (BCVA) was 6/18 or better in 67 eyes (91.8%) at 1 week postoperatively and in 70 eyes (95.9%) at 6 weeks postoperatively. The results remained stable at 3 months and 6 months postoperatively. No significant intraoperative complications were encountered. The endothelial cell loss was 4.8% at the 3-month follow-up examination. CONCLUSION: When performed by an experienced surgeon, SLIMCE-K is a safe and effective procedure that can be performed independent of phacoemulsification machines. It can be used in any nuclear grading of cataract hardness that is common in developing countries.