Visual outcome of microincision cataract surgery with implantation of an Acri.Smart lens

Abstract

To evaluate visual and refractive outcome of microincision cataract surgery (MICS) with implantation of an Acri. Smart 48S intraocular lens (IOL) (Acri.Tech) through a sub-1.9 mm incision. Vissum/Instituto Oftalmologico de Alicante and Ophthalmology Department, Miguel Hernandez University, Alicante, Spain. In this consecutive prospective observational noncomparative clinical trial, 45 eyes were included. Microincision cataract surgery was performed through a 1.9 mm or smaller clear corneal incision using low ultrasound power MICS. The IOL was injected using a hydraulic cartridge and injector. The final size of the clear corneal incision, postoperative uncorrected and best corrected near and distance acuities, lens stability, ease of implantation, rate of posterior capsule opacification (PCO), and complications were reported up to 6 months. The Acri. Smart lens was inserted through mean incision of 1.5 mm +/- 0.3 (SD). The mean uncorrected distance visual acuity improved significantly from 20/100 (0.2 +/- 0.2 decimal value) preoperatively to 20/32 (0.7 +/- 0.3) by the end of 6 months postoperatively (P<.000). The best corrected distance visual acuity improved significantly from 20/50 (0.4 +/- 0.2) preoperatively to 20/25 (0.9 +/- 0.2) after 6 months (P<0.000). The uncorrected near visual acuity at the end of 6 months was 20/32 (0.6 +/- 0.2, P<.000). The mean postoperative spherical equivalent was -1.1 +/- 0.9 diopters (P<.947). The safety index was 2.5 for distance and 1.4 for near. There were no intraoperative or postoperative complications. No eye had a neodymium:YAG laser capsulotomy for PCO or reported undesirable complications at the end of 6 months. Results show that the Acri. Smart 48S IOL is a safe, effective, and stable lens that could be inserted through sub-1.9 mm incisions. It provided excellent surgical performance, predictability, and some degree of pseudoaccommodation.