because of the trapezoidal shape. This concept of irri- gation-aspiration flat tool is a new way of conserving the wound (Fig. 2.40).

Take Home Pearls

ßThe right choice of instruments will help the surgeon in the transition.

ßWatertight incisions, especially during phacoemulsification and proper I/A instruments

should be used.

ßFluidics should be improved by increasing the inflow and reducing outflow by use of other

specific devices such as cruise control, which now is useful to improve MICS surgery at a high vacuum level.

References

1.Alio JL, Rodriguez-Prats JL, Vianello A, Galal A. Visual outcome of microincision cataract surgery with implantation of Acri.Smart lens. J Cataract Refract Surg 2005; 31: 1549–1556

2.Tsuneoka H, Shiba T, Takahashi Y. Ultrasonic phacoemulsification using a 1.4 mm incision: clinical results. J Cataract Refract Surg 2002; 28: 81–86

3.Alió JL. What is the future of cataract surgery? Ocular Surg News 2006; 17: 3–4

4.Kelman CD. Phaco-emulsification and aspiration. A new technique of cataract removal. A preliminary report. Am J Ophthalmol 1967; 64: 23–35

5.Alio JL, Rodriguez Prats JL, Galal A. MICS micro-incision cataract surgery. Highlights of Ophthalmology International, Miami, 2004

6.Shearing S, Relyea R, Loaiza A, Shearing R. Routine phacoemulsification through a 1.0 mm nonsutured incision. Cataract 1985; 2: 6–11

7.Alió JL, Rodriguez-Prats JL. Buscando la excelencia en la cirugía de la catarata. Glosa, Barcelona, 2006

8.Berdahl JP, DeStafeno JJ. Corneal wound architecture and integrity after phacoemulsification evaluation of coaxial, microincision coaxial, and microincision bimanual techniques. J Cataract Refract Surg 2007; 33: 510–515

9.Taban M, Behrens A, Newcomb RL, Nobe MY, Saedi G, Sweet PM, McDonnell PJ. Acute endophthalmitis following cataract surgery: a systematic review of the literature. Arch Ophthalmol 2005; 123: 613–620

10.Nagaki Y, Hayasaka S, Kadoi C, Matsumoto M, Yanagisawa S, Watanabe K, Watanabe K, Hayasaka Y, Ikeda N, Sato S, Kataoka Y, Togashi M, Abe T. Bacterial endophthalmitis after small-incision cataract surgery. Effect of incision placement and intraocular lens type. J Cataract Refract Surg 2003; 29: 20–26

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

12.Elkady B, Alió JL, Ortiz D, Montalbán R. Corneal aberrations after microincision cataract surgery. J Cataract Refract Surg 2008; 34: 40–45

13.Dogru M, Honda R, Omoto M, Fujishima H, Yagi Y, Tsubota K, Kojima T, Matsuyama M, Nishijima S, Yagi Y. Early visual results with the rollable ThinOptX intraocular lens. J Cataract Refract Surg 2004; 30: 558–565

14.Guirao A, Tejedor J, Artal P. Corneal aberrations before and after small-incision cataract surgery. Inves Ophthalmol Vis Sci 2004; 45: 4312–4319