Summary and ConclusionPelvic osteotomies are performed to correct a deficient acetabulum to provide adequate coverage for the femoral head and prevent or correct subluxation and dislocation of the hip.The goal of pelvic osteotomies is to reorient the acetabular weight-bearing surface over the femoral head so the area of direct weight bearing is increased. These decrease load per unit area, which is essential in slowing secondary degenerative changes and reducing pain.Pelvic osteotomies can be classified into two main categories: The first category is the reconstructive pelvic osteotomies (acetabulum rotation osteotomies). They involve a redirection of the acetabulum, with the aim of providing hyaline cartilage as a cover for the femoral head as the main benefit. They require that the femoral-acetabular surfaces be congruent and that the femoral subluxation be reducible, or nearly so. They include the single innominate osteotomy, which is done for immature pelvis. They also include the double innominate osteotomy, the triple innominate osteotomy, and the spherical osteotomies, which are done for mature pelvis.Reconstructive procedures involve also a reshaping of the acetabulum by folding down the superior surface of the acetabulum which is much larger and has an upward sloping lip for the articulating femoral head. They include Pemberton’s and Dega’s osteotomies.The second category is the salvage pelvic osteotomies. These provide for increased bony coverage of the femoral head without redirecting the articular surfaces. This technique relies upon capsular interposition with subsequent fibrocartilage formation and bone remodeling to create an improved containment surface. Congruency is a less important feature. They include the Chiari’s and shelf osteotomies which are generally reserved for severely incongruous and unstable hip joints in which no portion of acetabulum has been spared from the incongruity and in which the range of motion is limited.The Salter’s redirectional pelvic osteotomy is made approximately 1 cm. above the anterior inferior iliac spine, and it goes completely through the innominate bone into the sciatic notch. It corrects anterior and lateral deficiency. In subluxated hips, the innominate osteotomy is performed alone, while in dislocated hips, the innominate osteotomy is combined with open reduction.In double innominate osteotomy, a pubic osteotomy is done in addition to the standard Salter’s innominate osteotomy to isolate the acetabular segment and allowing a greater amount of rotation than can be accomplished with single innominate osteotomy.In Steel’s triple osteotomy, three osteotomies of the ischium, pubis and ilium are done as close to the acetabulum as possible. It almost allows full correction. Other similar procedures (as Tonnis procedure) have been described having the same concept and principles.Ganz periacetabular osteotomy involves a series of straight cuts and a controlled fracture to separate the acetabulum from the surrounding pelvis and displacing the joint medially as needed. In addition, the acetabulum can be extended as necessary to improve the anterior stability of the hip joint.Rotational acetabular (Wagner) osteotomy is a periacetabular osteotomy in which the acetabulum is osteotomized in a semispherical shape at the external region of the joint capsule and rotated en bloc anterolaterally. It is indicated in highly dysplastic hip.In Pemberton’s (pericapsular) osteotomy, the osteotomy starts above the anteroinferior iliac spine until the triradiate cartilage, it requires the presence of an open and reasonably flexible triradiate cartilage so, it can be done for children 18 months till the age of 14 years.We found No statistically significant difference between the coaxialphaco and the bimanual microincision phaco as regard EPT, amount of irrigation fluid used, total operation time, postoperative inflammation ,postoperative CCT, IOP, uncorrected and best corrected visual acuity and the incidence of intra- or postoperative complications.The bimanual microincision phaco was proved to produce statistically significant lower surgical induced astigmatism (SIA) in comparison to the conventional coaxial phaco.Conclusion:The bimanual microincision phaco is a safe and effective technique for phacoemulsification with the advantage of less surgical induced astigmatism.