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J. L. Alió et al.

Nowadays, the vitrectomy TSV25 infusion cannula is inserted into the eye after finishing the MICS surgery. Thus, this combination of microphakonit with TSV25 makes the combined procedure faster and minimally invasive.

1.3.6 Summary

With 700 μm cataract surgery, a 0.7 mm MICS set is used to remove the cataract. At present, this is the smallest set of instruments that can be used for cataract surgery. With time, surgery will be able to be performed with smaller and better instruments and devices. The advantages of 0.7 mm MICS are highly estimated by the authors. Surgically induced astigmatism and induced aberrations are practically eliminated, and the EPT is minimal [25]. The problem at present is with the IOL. Good-quality IOLs are required which can pass through sub-1 mm cataract surgical incisions so that the real benefit of 0.7 mm MICS can be experienced by the patient.

Take Home Pearls

ßPressured fluidics, new phaco tip and new irrigation instruments are necessary.

ßCombined procedures are possible with greater control for treatment of multiple diseases such

as glaucoma and vitreous.

ßSince no IOL is available so far for 0.7mm MICS, the enlargement of the incision to 1.6mm

is mandatory.

References

1.Agarwal A, Agarwal C, Agarwal AT. The Phakonit Thinoptx IOL. In Agarwals A (ed) Textbook Presbyopia. Slack, USA, 2002; pp 187–194

2.Pandey S, Wener L, Agarwal A, Agarwal S, Agarwal At, Hoyos J. Phakonit: cataract removal through a sub 1.0 mm incision with implantation of the Thinoptx rollable IOL. J Cataract Refract Surg 2002; 28:1710

3.Agarwal A, Agarwal S, Agarwal AT. Phakonit with an acritec IOL. J Cataract Refract Surg 2003; 29:854–855

4.Tong N, He JC, Lu F, Wang Q, Qu J, Zhao YE. Changes in corneal wavefront aberrations in microincision and smallincision cataract surgery. J Cataract Refract Surg 2008; 34(12):2085–2090

5.Yao K, Tang X, Ye P. Corneal astigmatism, high order aberrations, and optical quality after cataract surgery: microincision versus small incision. J Refract Surg 2006; 22(9 Suppl):S1079–S1082

6.Agarwal A, Agarwal S, Agarwal AT. No anesthesia cataract surgery. In Agarwal A (ed)Textbook Phacoemulsification, Laser Cataract Surgery and Foldable IOL’s, 1st edn. Jaypee, India, 1998; pp 144–154

7.Pandey S, Wener L, Agarwal A, Agarwal S, Agarwal AT. Apple D: no anesthesia cataract surgery. J Cataract Refract Surg 2001; 28:1710

8.Agarwal A, Agarwal S, Agarwal AT. Phakonit: a new technique of removing cataracts through a 0.9 mm incision. In Agarwal A (ed) Textbook Phacoemulsification, Laser Cataract Surgery and Foldable IOL’s, 1st edn. Jaypee, India, 1998; pp 139–143

9.Agarwal A, Agarwal S, Agarwal AT. Phakonit and laser phakonit: lens surgery through a 0.9 mm incision. In Agarwal (ed) Textbook Phacoemulsification, Laser Cataract Surgery and Foldable IOL’s, 2nd edn. Jaypee, India, 2000; pp 204–216

10.Agarwal A, Agarwal S, Agarwal AT. Phakonit: phacoemulsification through a 0.9 mm incision. J Cataract Refract Surg 2001; 27:1548–1552

11.Agarwal S, Agarwal A, Agarwal AT. Phakonit with Acritec IOL. Highlights of ophthalmology, Panama, 2000

12.Alio J. What Does MICS Require in Alio´s Textbook MICS. Highlights of Ophthalmology, Panama 2004; pp 1–4

13.Agarwal A, Agarwal S, Agarwal AT. Phakonit. In Agarwal (ed) Textbook Phacoemulsification, Laser Cataract Surgery and Foldable IOL’s, 3rd edn. Jaypee, India, 2003; pp 317–329

14.Agarwal A, Agarwal S, Agarwal AT. Phakonit and laser phakonit. In Boyd B, Agarwal A, et al (eds) Textbook Lasik and Beyond Lasik. Higlights of Ophthalmology, Panama, 2000; pp 463–468

15.Agarwal A, Agarwal S, Agarwal AT. Phakonit and laser phakonit-cataract surgery through a 0.9 mm incision. In Boyd B, Agarwal A, et al. (eds) Textbook Phako, Phakonit and Laser Phako. Higlights of Ophthalmology, Panama, 2000; pp 327–334

16.Agarwal A, Agarwal S, Agarwal AT. Antichamber collapser. J Cataract Refrac Surg 2002; 28:1085

17.Agarwal A. Air pump. In Agarwal A (ed) Bimanual Phaco: Mastering the Phakonit/MICS Technique. Slack, USA, 2005

18.Alio J, Rodriguez-Prats JL, Galal A. Advances in microincision cataract surgery intraocular lenses. Curr Opin Ophthalmol 2006; 17:80–93

19.Alió JL, Schimchak P, Montés-Micó R, Galal A. Retinal image quality after microincision intraocular lens implantation. J Cataract Refract Surg 2005; 31:1557–1560

20.Alio J. MICS in complicated cases (including management of complications in MICS). In XXX Seminar in Microincision Cataract Surgery, Riyadh, Saudi Arabia, 13–14 October 2008

21.Maris PJ, Smith ME, Netland PA. Clinical outcomes with the ExPress miniature glaucoma implant. Invest Ophthalmol Vis Sci 2005; 46:E-Abstract 71

1.3 0.7 mm Microincision Cataract Surgery

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22.Nyska A, Glovinsky Y, Belkin M, Epstein Y. Biocompatibility of the Ex-PRESS miniature glaucoma drainage implant. J Glaucoma 2003; 12(3):275–280

23.Agarwal A, Trivedi RH, Jacob S, et al. Microphakonit: 700 micron cataract surgery. Clin Ophthalmol 2007; 1(3): 323–325

24. Agarwal A, Jacob S, Agarwal AT. Combined microphakonit and 25-gauge transconjunctival sutureless vitrectomy. J Cataract Refract Surg 2007; 33:1839–1840

25.Alio J.L, Rodriguez-Prats JL, Galal A, Ramzy M. Outcomes of microincision cataract surgery versus coaxial phacoemulsification. Ophthalmology 2005; 112:1997–2003