I am so fortunate to travel extensively around the world to lecture in many countries and in most places surgeons learn MSICS before advancing to phacoemulsification. That is not the case in the USA (and many other countries) and that is unfortunate because MSICS provides some clear advantages over phaco for certain cases. While 98% of my cataract cases are phaco, I still perform about 1-2 MSICS surgeries per month in Los Angeles. In the USA most residency programs do not teach MSICS and that is a mistake. MSICS has supplanted ECCE (with those dreaded corneo-scleral scissors) as the top choice for manual extraction of the entire nucleus. Look at this case previously featured and tell me if you would have rather performed phaco!
