Latest-generation accommodating lens produces optimal visual outcomes, spectacle independence

ROME — Microincision cataract surgery with implantation of the Crystalens HD from Bausch & Lomb is a safe and reliable procedure that produces optimal visual outcomes at all distances and a high degree of spectacle independence, as shown by the preliminary results of a study.

The latest generation of the accommodating Crystalens is a silicone, plate style implant with a 5-mm optic.

Cataract surgery was performed at Antwerp Eye Center in Belgium with the Stellaris phaco system platform (Bausch & Lomb), which "is a very efficient platform to perform MICS, maintaining an incredibly stable anterior chamber," Erik Mertens, MD, said at the winter meeting of the European Society of Cataract and Refractive Surgeons.

To implant the lens, the incision was enlarged after surgery to 2.8 mm and the lens was injected under the 5.5-mm capsulorrhexis.

Once inside, the lens should be able to rotate, Dr. Mertens said.

"If you cannot spin, it isn't in. Also, ensure that the optic of the lens is folded posteriorly," he said.

At the end of surgery, a drop of atropine is used.

In Dr. Mertens' series, for distance vision, 82% of the eyes achieved 20/40 or better, 55% achieved 20/32 or better, 45% achieved 20/25 or better, and 30% achieved 20/20 or better.

Uncorrected intermediate vision was good, with 91% of the eyes achieving 20/40 and almost 75% achieving 20/20 or better. At near, 82% were able to read J3, 73% could read J2, and 41% could read J1 or better.

"A high degree of spectacle independence was achieved, with 88% of the patients using no glasses for distance, 94% not using them for reading and 81% never using them at all," Dr. Mertens said.