Scleral tunnel incision is an alternative to clear corneal incisions, where the external opening is placed on the sclera instead of near the limbus. This requires a long tunnel from the internal and external opening during cataract surgery and utilizes three interlocking incisional planes to create a superior sealing function. Its sideways profile is also like ECCE, and this incision can be widened to convert to manual small incision cataract surgery (MSICS) or extracapsular cataract extraction (ECCE). Because this incision has a low astigmatic effect, it is often preferred for pediatric cataracts and for surgeries where corneal incisions should be avoided, such as after radial keratotomy (Soare C, Patel DS, Ionides A. Cataract surgery outcomes in eyes with previous radial keratotomy. Eye 36(9):1804–1809. https://doi.org/10.1038/s41433-021-01716-6 , 2022). It does, however, require the use of a partial peritomy, wherein an incision is made at the limbus and a section of conjunctiva is reflected backwards to reveal the underlying bare sclera.