What Is MICS Cataract Surgery?

Cataracts occur due to clouding your natural lens, leading to vision abnormalities, and is treated surgically by removing the damaged lens and replacing it with a new artificial intraocular lens (IOL). There have been many surgical techniques for successfully treating cataracts. However, the MICS (Microincision Cataract Surgery) technique is gaining immense popularity due to its minimally invasive (there is less trauma to other structures with small incisions and faster recovery) procedure. 

As the name suggests, the incisions are very small (less than 2mm), with fewer postoperative complications and faster healing. It helps you resume your activities in a short time.

Read on to learn more about MICS, the procedure involved, its advantages over other surgical procedures, and its drawbacks.

What is MICS?

This cataract surgery technique uses small incisions of 1.8 mm to remove the faulty clouded lens and replace it with an intraocular lens (IOL). It is a safe, effective, and minimally invasive procedure that provides good visual outcomes.

MICS is an advanced technique of phaco surgery for cataract removal. It uses lesser phaco energy or ultrasound during surgery. Soft foldable lens implants are used as compared to hard plastic lenses that were used earlier. It is a safer procedure with fewer postoperative complications and quicker healing. This new technique has made things simple and easy for the patient and surgeon.

Who Needs a MICS?

If you have been diagnosed with cataracts, your surgeon will examine your eyes and may suggest you to undergo cataract surgery. Your surgeon will discuss many surgical techniques suitable for cataract removal, and MICS is one of them as patient satisfaction and vision restoration is better after MICS compared to other techniques. Individuals with all types, grades, and severity of cataracts can be treated with MICS.

How is MICS performed?

MICS is an outpatient and increasingly popular technique. It usually takes around 20 to 30 minutes to complete the procedure.

• Pre-procedure

• • Your eye surgeon will record your detailed medical and family history to check for any medical condition like diabetes (increased blood glucose levels), hypertension (increased blood pressure), and other blood disorders.
  • You should inform your surgeon about any allergies and the medications you are currently taking. 
  • Your surgeon will check the affected eye for its shape and size. This is done to determine the lens type required for implantation.
  • Your surgeon will inform you about the procedure’s cost, benefits, and risks.
  • Your surgeon will also brief you on the instructions before and after the procedure.
  • Your surgeon will inform you of the time you need to stay away from work post-surgery. This will enable your eyes to heal properly. Your vision after the surgery may remain cloudy for some days; hence, you need to make some help at home post-surgery to ensure that you are comfortable after your surgery.
  • You should inform your surgeon about any medications or supplements you are taking, as you may need to stop some before surgery. If you are on antihistamines, your doctor may advise you to stop taking them 3 days before your surgery. If you are on blood thinners, you may need to stop them a few days before surgery, as advised by your surgeon, as if not stopped may lead to increased bleeding during the surgery.
  • You will be advised to stop using contact lenses at least 2 weeks before the scheduled surgery date. If you use rigid gas-permeable contact lenses, you should stop their use 3 weeks before surgery. These contact lens can change the shape of the eye and interfere with your surgery. Not wearing them for a few weeks before surgery will ensure a successful surgery and favorable outcomes,
  • You may be given eyedrops to be used 4 days before the surgery, which can be continued after the surgery to reduce the infection and inflammation that will occur after the surgery.
  • You will be asked to stop smoking and limit your alcohol intake for a few days before surgery. Smoking decreases the moisture in the eyes and may lead to dry eye syndrome. Smoking has also been shown to accelerate the development of cataracts. Studies have shown that smokers are twice as likely to develop cataracts when compared to non-smokers. Alcohol consumption can cause vision changes in the short term and long run. Short-term effects can include difficulty in the peripheral vision leading to tunnel vision. Long-term effects of consuming alcohol can lead to the development of premature cataracts, double vision, blurring of vision, and atrophy of the optic nerve leading to blindness.
  • You will be asked to arrange for someone to drive you to your surgery and back home after the surgery, as cataract is an outpatient procedure, and you will be permitted to go home the same day. The medications that will be given during the procedure can make you drowsy and giddy, making it difficult to drive or use public transport. Ensure that a family member is present with you on the day of the surgery.
  • You will be asked to fast for  8 – 12 hours before the surgery.

• • On the Day of The Procedure
    • Do not skip medications- If you are on some medications for your disease, take your medications before surgery (after consultation with your surgeon)
    • Do not wear cologne, perfume, or any products with fragrances- It will cause inconvenience to the surgeon operating on your eye.
    • Do not use any product that contains alcohol like hairspray, after-shave, perfumes, etc.,- They can interfere with the procedure.
    • Do not wear makeup and jewelry while coming to the surgery- It will interfere with the laser for your surgery.
    • Wear loose and comfortable cotton clothes for the surgery – You will be relaxed during surgery and will not be sweating.
    • Do not smoke just before your surgery- It may cause increased dryness of the eyes which can hamper your recovery.
    • Do not drink alcohol before coming for surgery- It will cause dehydration of the tissues and will delay recovery.
    • Do not come for surgery if you are sick- If you are not well, have a temperature, etc., please inform your surgeon. Your surgeon will reschedule the surgery.

• Procedure

• • You will ask to lie on the operating table.
  • Your surgeon will irrigate your eye with an antiseptic solution.
  • An eyelid holder will be used keep your eyes open during the procedure
  • Your surgeon will make incisions as small as 1.8 mm at the edge of the cornea.
  • Your surgeon will first perform this technique in 4 steps
    •  “Chopping” -.An ultrasonic machine is used with a hand-held device with different angled tips. The machine consists of a handpiece, foot pad, irrigation and aspiration system.This device breaks the lens into small fragments which are suctioned out through a vacuum. This procedure is called “chopping”.
    • “Irrigation”- Here, the lens is broken into a gel-like mass which is flushed out and irrigated with sterile fluids. 
    • “Aspiration”- After irrigation, your surgeon will perform th suctioning of the fragments through a vacuum.
    • “Insertion of IOL”- Finally, a foldable IOL is inserted through this incision.
  • This procedure does not require any stitches to be used after surgery. 

• Post-procedure

Since it is an outpatient procedure, there is no hospitalization and you will need someone to drive you back home.

• You will have blurred vision for the first 24 hours after the surgery. 
• You will be able to resume activities like watching TV, reading, etc, from the next day.
• Your surgeon will prescribe you the following eye drops:
  • Antibiotic eye drops- help to eliminate harmful bacteria to prevent and reduce risk of post surgical complications.
  • Steroid eye drops- help to reduce pain, inflammation and redness around the operated eye. 
  • Lubricating eye drops – to prevent dryness of the eye.
  • Anti-inflammatory eye drops- to reduce pain and swelling.
• You will be given a protective eye shield to be used during nighttime to prevent injury and accidental rubbing of the operated eye.
• You will be advised to wear sunglasses outdoors to protect your lens from getting damaged..
• You should avoid washing your face and head baths for at least 2 weeks as water and chemicals may enter your eyes and increase the risk of infections.
• You will be asked to avoid eye makeup for 3 to 4 weeks after the surgery to prevent any chemicals from affecting and damaging the new lens.

What Are The Advantages of MICS Over Other Procedures?

MICS is an immensely popular cataract surgery that is safe and yields good visual outcomes. The following are some advantages of MICS over other surgical techniques:

• The technique involves small incisions, which means quick healing and faster vision recovery.
• There is a lesser risk of astigmatism (defect in the eye or lens due to a deviation from spherical curvature, resulting in distorted images) since the incisions made are small and do not alter the original shape of the eye.
• There is less need for corrective glasses postoperatively.
• It is the best choice for diabetic patients since the healing is quick.
• There are minimal restrictions postoperatively. 
• There are fewer follow-up visits to the surgeon.
• No anesthesia, stitches, or bandages are required.
• The procedure involves a quick return to normal activities.
• It is most compatible with premium IOLs (intraocular lenses).
• Recovery with MICS is quick and fast when compared to phacoemulsification. 

What Are The Drawbacks of MICS?

Even though MICS has been considered a superior surgical technique compared to phacoemulsification, this technology has a few drawbacks:

• It is an expensive procedure due to the special instruments used and the additional training required for the surgeons to perform this procedure; hence very few surgeon have expertise in this procedure..
• If you do not desire premium IOLs, then the technique would not be useful for you.
• Your eye surgeon would require additional training in this technique, especially in the fluidics-phaco energy combination.
• Some surgeons believe IOL insertion with power greater than +26 Diopters is challenging.

Takeaway

MICS is considered a minimally traumatic surgery, providing better postoperative outcomes than standard phacoemulsification. It is an approach through incisions less than 2mm with fewer postoperative complications. MICS is significantly increasing in popularity compared to other surgical techniques. The ultrasonic energy breaks the damaged lens into tiny fragments easily suctioned out through a vacuum.

The expert team of eye specialists at Medfin, are adept at handling the complex procedure of MCIS. We excel in delivering the best eye care treatment with state-of-the-art technology because we believe every eye deserves the best.

Disclaimer: 

The content on this site is the copyright of Medfin and is intended for informational and educational purposes only. This should not be considered as a substitute for medical and surgical expertise. Results from any treatments or surgeries are subjective to an individual patient and the type of procedure/ surgery performed. Please seek professional help regarding any medical concerns. Medfin will not be responsible for any act or omission arising from the interpretation of the content present on this page.