Ophthalmology Times: Dr. Vasavada examined tissue samples of eyes that underwent 2.2mm vs. 1.8 mm incisions, and found greater damage and collagen denaturation in the latter. I’m not surprised. I have read several pieces of the difficulty some surgeons have in the learning curve t0 1.8, and I assume there is more manipulation and stretching. I have not read anything that suggests 1.8 is significantly better astigmatically compared to 2.2, and I doubt it’s worth the time and expense and skills needed to adjust to such a small incision, unless the instrumentation takes a giant leap.