Microincision prelex yields impressive visual results

Excellent visual results can be obtained with microincision prelex in selected patients bilaterally implanted with the Acri.Lisa lens (Acri.Tec) through a 1.5 mm incision and combined with astigmatic surgery when needed, said Dr Dominique Pietrini, of the Clinique de la Vision in France, at today's Acri.Tec symposium.

"In microincision prelex, refractive lens exchange is performed through a 1.5 mm incision so the surgery does not induce astigmatism, which is 0.2 D or below. This allows the surgeon to then correct pre-existing astigmatism," said Dr Pietrini.

"You need to achieve emmetropia and for that optical biometry must be very good, with the highest precision, and you need the clearest optics," he said. "Then a secondary treatment of ametropia will be exceptional."

Dr Pietrini's opinion is based on the findings of his study, which included 150 eyes of 75 patients with presbyopia who had clear lenses with low opacities and a good potential visual acuity (VA). All patients were over 45 years and follow-up was at least six months. Implanted power ranged from 17 to 26 D, with a mean of 20 D.

The bimanual surgery consisted of a microincision ≤1.5mm. There was regular corneal astigmatism between 0 and 2.0 D, with surgical correction when >1.25 D.

Binocular uncorrected far VA was 96% at 0.00 logMAR, while uncorrected near VA was 100% between 0.06 and 0.18 logMAR. Contrast sensitivity (CS) for binocular UCVA ranged between -0.10 (high CS) and +0.10 (low CS) logMAR, while monocular UCVA ranged between 0.00 (high CS) and +0.20 (low CS).

Patients reported never using glasses in 92% of cases, with the other 8% using them only occasionally. Side effects included minimal night vision for 30% of patients and minimal halo for 15%. Minimal glare was reported in 50% of patients, while 10% reported moderate glare. In any case, all patients were satisfied with the lens and said they would recommend it.

Dr Pietrini concluded that microincision prelex in selected patients bilaterally implanted with Acri.Lisa through 1.5 mm incision provided excellent visual results for near and far with good intermediate vision, CS and a low rate of side effects. "The results show that microincision prelex is real refractive surgery of the crystalline lens," he said. "We now need a longer follow-up in order to establish the rate of secondary cataracts and whether there are complications with retinal detachment,- Dr Pietrini concluded.