Aspheric microincision intraocular lens implantation with biaxial microincision cataract surgery: Efficacy and reliability _ Izzet Can, MD, Tamer Takmaz, MD, Hasan Ali Bayhan, MD, Bas ¸ak Bostancı Ceran, MD PURPOSE: To evaluate the efficacy and reliability of a microincision intraocular lens (IOL) and its use in biaxial microincision cataract surgery (MICS). SETTING: Atatu ¨rk Training and Research Hospital, Ankara, Turkey. DESIGN: Prospective clinical study. METHODS: A microincision IOL (Akreos MI60) was implanted after cataract extraction by the biaxial MICS technique. Over a postoperative follow-up of 12 months or more, visual acuity, contrast sensitivity, surgically induced astigmatism (SIA), corneal and ocular aberrations, and early and late complications were recorded. RESULTS: The IOLs were implanted in the capsular bag in all 100 eyes. The mean final incision size was 1.82 mm G 0.09 (SD). Postoperatively, the mean corrected distance visual acuity was 0.06 G 0.10 logMAR; the mean spherical equivalent, À0.48 G 0.91 diopter (D); and the mean calculated SIA, 0.20 G 0.22 D. Contrast sensitivity with and without glare was within normal limits. There was no statistically significant difference in the root mean square of total corneal aberrations between preop- eratively and postoperatively. Ocular wavefront analysis 3 months postoperatively showed mean values of 0.15 G 0.2 mm for spherical aberration, 0.38 G 0.16 mm for higher-order aberrations, 0.18 G 0.14 mm for coma, and 0.14 G 0.08 mm for trefoil. The 4 cases (4.0%) of membranous anterior chamber reaction resolved with treatment. None of the 20 eyes (20.0%) with posterior capsule opacification required neodymium:YAG capsulotomy. All IOLs remained well centered. CONCLUSION: The aspheric microincision IOL was safely implanted through a 1.8 mm or smaller incision during biaxial MICS and gave good postoperative outcomes. Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. J Cataract Refract Surg 2010; 36:1905–1911 Q 2010 ASCRS and ESCRS Advances in surgical technique and technology have significantly changed cataract surgery methods in the past decade. Cataract extraction can now be performed through incisions smaller than 2.0 mm using biaxial microincision cataract surgery (MICS) 1–3 or microcoax- ial phacoemulsification 4,5 methods. These techniques require intraocular lenses (IOLs) that can be implanted through a very small incision. Until recently, the micro- incision IOLs on the market had disadvantages and did not have the positive features of standard conventional and existing IOLs. 6–8 The ideal IOL for MICS can be implanted through incisions smaller than 2.0 mm without incurring permanent structural or optical changes when com- pressed or rolled for implantation. The IOL should also have high biocompatibility, be stable in the capsular bag, and not increase the risk for posterior capsule opacification (PCO). Its optical performance should continue in vivo, and it should not induce positive or negative dysphotopsia, light scattering, or aberrations. In short, it must have similar or better visual results than conventional IOLs. Paralleling the developments in cataract surgery is the availability of new-generation IOLs acceptable for implantation through microincisions. 9,10 Biaxial MICS can be performed through clear corneal incisions (CCIs) smaller than 1.8 mm. The 2 goals are to reduce intraoperative trauma and improve optical outcomes. There are several advantages to the MICS technique. It reduces the amount of surgically Q 2010 ASCRS and ESCRS Published by Elsevier Inc. 0886-3350/$dsee front matter 1905 doi:10.1016/j.jcrs.2010.06.057 ARTICLE