Can a MICS IOL also be a Toric IOL?

I have been implanting the *Acri.Smart MICS IOL (*Acri.Tec AG; Germany) since 2001 using a bimanual technique, which involves the use of the Dodick Laserlysis system (A.R.C. Laser; Germany).

My experience with these lenses is quite extensive; approximately 8,000 *Acri.Smart MICS IOLs have been implanted in my clinic so far, and about half of those were personally implanted by me. The data available in various publications shows this to be an excellent MICS (microincision cataract surgery) IOL in terms of ease of implantation through an incision of 1.5 mm, refractive stability, secondary cataract formation and biocompatibility.

One important point that six years of experience with the lens has taught me is that it has excellent rotational stability. I am sure that those surgeons who have experience of injecting the IOL into the capsular bag, will have noticed the overall stability of the lens once it is in place; a property that I believe is unique to this lens.

The smart implantation

The following study was designed and carried out with the most widely available *Acri.Smart model at the time of the study, the *Acri.Smart 46S. A special set of *Acri.Smart 46S IOL's was produced with two marks in order to enable alignment of the axis with defined reference points in the eye.

Forty-three eyes (18 left eyes and 25 right eyes) of 37 patients (30 female, seven male patients) were enrolled into the prospective study. The average age of patients was 72±9.2 years (range 47 to 86 years).