Refractive Lens Exchange for Presbyopia: Pearls for Success
Narrative Responses:
Purpose
To evaluate our experience of 4 years with refractive lens exchange for presbyopia with multifocals, pointing out the required conditions for success.
Methods
200 presbyopic patients with clear lens were implanted with multifocal IOls (Restor +3.00) to achieve ametropia and presbyopia correction. Most (85%) were hyperopes. All were implanted bilaterally. The outcome measures were the UCVA for far and near, the accuracy of biometry,the rate of laser enhancement and patient satisfaction.
Results
All patients achieved a UCVA of 20/40 or better with more than 80% achieving 20/20. Residual refractive error was the reason. Biometry showed to be less accurate in high hyperopes. Concerning NUCVA all but 2 patients read J2 or better but some complained of requiring bright light for reading. Two patients complained of poor intermediate vision.Laser enhancement (Lasik or PRK) was performed in all cases required by the patients and emmetropia was achieved in every case (at no extra cost).Patient satisfaction was very high (97%).
Conclusion
Refractive lens exchange for presbyopia is very safe and effective with a very high satisfaction rate. The pearls for success are: selection of patients,bilateral implantation,accurate biometry and availability of laser viion correction (if necessary) at no extra cost.