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1710· Clinical Research ·Bimanual microincision cataract surgery with implantation of the new Incise ® MJ14 intraocular lens through a 1.4 mm incisionGian Maria Cavallini 1 , Tommaso Verdina 1 , Michele De Maria 1 , Elisa Fornasari 1 , Giulio Torlai 1 , Veronica Volante 1 , Simone Donati 2 , Carlo Cagini 31 Institute of Ophthalmology, University of Modena, Modena 41100, Italy2 Department of Surgical and Morphological Sciences, Section of Ophthalmology, University of Insubria, Varese-Como 21100, Italy3 Department of Surgical and Biomedical Sciences, University of Perugia, S. Maria della Misericordia Hospital, Perugia 06123, ItalyCorrespondence to: Tommaso Verdina. Institute of Ophthal-mology, University of Modena, Via del Pozzo 71, Modena 41100, Italy. tommaso.verdina@gmail.comReceived: 2017-02-13 Accepted: 2017-07-18Abstract● AIM: To analyze the visual outcomes and the posterior capsule opacification (PCO) with the new Incise ® MJ14 intraocular lens (IOL) implanted through a 1.4 mm clear corneal incision (CCI) in patients who underwent bimanual microincision cataract surgery (B-MICS). ● METHODS: Eighty eyes which underwent cataract surgery using B-MICS technique performed by the same experienced surgeon were included in the study: 40 eyes were implanted with an Incise ® MJ14 IOL through a 1.4 mm CCI (group A) without enlargement of the main CCI, while 40 eyes were implanted with an Akreos ® MI60 IOL with enlargement of the main CCI to 1.8 mm (group B). Best corrected visual acuity (BCVA), astigmatism and endothelial cell loss were evaluated before and after surgery at 7, 30d and 6mo. Anterior segment-optical coherence tomography (AS-OCT) of CCI was performed at 1, 3, 7, 30d, 6 and 18mo. PCO incidence was evaluated at 18mo using EPCO 2000 Software. ● RESULTS: Mean BCVA improvement and endothelial cell loss were statistically signif i cant at 18mo in both groups with no difference between the two groups; no statistically significant difference in surgically induced astigmatism (SIA) was noticed in the two groups. At AS-OCT the only signif i cant alterations in the CCI were endothelial gaping and local detachment of Descemet’s membrane at 1 and 7d after surgery; no statistically significant alterations were found at 1, 6 and 18mo. PCO score at 18mo was 0.03±0.07 for group A and 0.08±0.18 for group B (P=0.11) with no sign of central optic plate invasion in both groups.● CONCLUSION: The implant of the new Incise ® MJ14 IOL through a 1.4 mm CCI and B-MICS technique appeared to be a safe and effective procedure with rapid visual recovery. PCO rate resulted very low and the CCI presented few morphological alterations which were only detectable in the first days postoperatively and achieved fast corneal healing during the long-term follow-up.● KEYWORDS: cataract surgery; bimanual microincision cataract surgery; posterior capsule opacification; anterior segment-optical coherence tomography; intraocular lens; clear corneal incisionDOI:10.18240/ijo.2017.11.12Citation: Cavallini GM, Verdina T, De Maria M, Fornasari E, Torlai G, Volante V, Donati S, Cagini C. Bimanual microincision cataract surgery with implantation of the new Incise ® MJ14 intraocular lens through a 1.4 mm incision. Int J Ophthalmol 2017;10(11):1710-1715INTRODUCTIONThanks to continuous improvements in technology and surgical techniques cataract surgery has become a safer and more eff i cient procedure over the years. An important role in the evolution of this surgery has been the chance to perform the entire procedure through smaller clear corneal incisions (CCI), thus allowing safer surgery and faster visual recovery for the patients resulting in better outcomes [1] . Nowadays technological innovations and the bimanual microincision cataract surgery (B-MICS) technique permits the surgical procedure through CCIs which are smaller than 2.0 mm [2] . B-MICS is a micro-invasive variant of the traditional coaxial phacoemulsification (C-MICS) and it is characterized by the separation of the aspiration and the infusion probes which permits microincisions of 1.4 mm [3-4] . For this reason we believe that this is an ideal technique for cataract extraction due to increased anterior chamber stability, lower postoperative inflammation, reduced surgically induced astigmatism (SIA) and rapid incision healing [1,3-7] .The implantation of the intraocular lens (IOL) is usually performed with an enlargement of the main CCI from 1.4 to 1.8 or 2.2 mm; this leads to the instability of the corneal incision because in the B-MICS technique it is a monoplanar Bimanual cataract surgery and Incise ® MJ14Published online：2017-11-08 09:54:24URL：http://kns.cnki.net/kcms/detail/CN.20171108.0954.024.html