The aim of this study was to analyse the clinical outcome and higher-order aberrations (HOAs) after 1.4mm biaxial micro incision cataract surgery (B-MICS) and implantation of a new aspheric intraocular lens (IOL). A total of 157 eyes of 106 patients were enrolled in this study. The B-MICS (1.4mm, 26 eyes) was followed by an implantation of a micro incision aspheric Incise® IOL MJ14T (Bausch & Lomb, Rochester, NY, USA). The control groups consisted of patients operated with 1.8mm (coaxial MICS, Akreos MI60, 41 eyes), 2.2mm (small incision cataract surgery, Tecnis ZCB00, 44 eyes) and 2.2mm (small incision cataract surgery, CT Asphina, 46 eyes) coaxial phacoemulsification with implantation of an aspheric IOL. Intraoperative and postoperative complications, best-corrected visual acuity, HOAs for a 5.0mm pupil using the iTrace aberrometer and endothelial cell loss were evaluated. In the Incise group, the mean best-corrected visual acuity improved significantly from 0.4±0.27 logMAR preoperatively to 0.05±0.07 postoperatively. The root mean square of total ocular HOAs was measured at 0.419±0.191µm, spherical aberration was measured at 0.168±0.072µm and coma was measured at 0.213±0.200µm. The best-corrected visual acuity (p=0.097), total ocular HOA (p=0.630) and coma (p=0.193) showed no statistically significant difference between the four groups. The aspheric micro incision IOL was safely implanted through a 1.4mm incision and showed similarly good postoperative outcome in comparison to 1.8 and 2.2mm coaxial phacoemulsification.