OBJECTIVE To evaluate the efficacy and reliability of a microincision intraocular lens (IOL) and its use in biaxial microincision cataract surgery (MICS). METHODS Atatürk Training and Research Hospital, Ankara, Turkey. METHODS Prospective clinical study. METHODS A microincision IOL (Akreos MI60) was implanted after cataract extraction by the biaxial MICS technique. Over a postoperative follow-up of 12 months or more, visual acuity, contrast sensitivity, surgically induced astigmatism (SIA), corneal and ocular aberrations, and early and late complications were recorded. RESULTS The IOLs were implanted in the capsular bag in all 100 eyes. The mean final incision size was 1.82 mm ± 0.09 (SD). Postoperatively, the mean corrected distance visual acuity was 0.06 ± 0.10 logMAR; the mean spherical equivalent, -0.48 ± 0.91 diopter (D); and the mean calculated SIA, 0.20 ± 0.22 D. Contrast sensitivity with and without glare was within normal limits. There was no statistically significant difference in the root mean square of total corneal aberrations between preoperatively and postoperatively. Ocular wavefront analysis 3 months postoperatively showed mean values of 0.15 ± 0.2 μm for spherical aberration, 0.38 ± 0.16 μm for higher-order aberrations, 0.18 ± 0.14 μm for coma, and 0.14 ± 0.08 μm for trefoil. The 4 cases (4.0%) of membranous anterior chamber reaction resolved with treatment. None of the 20 eyes (20.0%) with posterior capsule opacification required neodymium:YAG capsulotomy. All IOLs remained well centered. CONCLUSIONS The aspheric microincision IOL was safely implanted through a 1.8 mm or smaller incision during biaxial MICS and gave good postoperative outcomes.