Incisions for phaco surgery are usually made either temporal or superior. For MSICS, we typically make the incision superior because it is a larger incision and it will be covered by the upper eyelid. But can we make the MSICS incision temporal instead? Yes, that is certainly possible and this video from our guest surgeon shows us how. Because the MSICS incision is larger than a typical phaco incision, it will induce more corneal flattening. For this reason, you can expect at least 1 diopter of astigmatic effect from the MSICS incision. Placing it temporal may help more in patients who have a larger degree of against the rule astigmatism.