There is no doubt that MSICS is a great procedure for a dense, brunescent, rock hard cataract. MSICS stands for manual small incision cataract surgery but since the incision is not that small (it’s quite large) I like to think of it as MSICS: manual shelved incision cataract surgery because the key is making the incision tunnel length with a particular architecture of a shelved incision. But what about for a softer cataract like in the case shown here? You can still perform the MSICS procedure but I would prefer to do phaco surgery instead. This would allow using about a 2 mm wide incision compared to the 8+ mm incision shown here. In all fairness, using the phaco machine adds a huge cost compared to doing MSICS which can be done with handheld instrumentation only. Have you performed MSICS for softer cataracts?