You must be wondering why I have been posting so many MSICS (manual small incision cataract surgery) videos in the past couple of months. It is because I want to encourage you to learn this technique. Even if you are a master surgeon with advanced modern-day cataract surgery like me, this is still a technique that you will find very useful in your own clinic. I used the MSICS technique twice last year in our surgery center which is in the world famous city of Beverly Hills, California. There are patients who will benefit from this technique, even in the home of the movie stars, celebrities, and ultra-wealthy. MSICS is not simply a technique for charity surgery mission trips and phaco is not always better. This case has some great teaching points about performing MSICS in a small pupil case.