title: [Multifocal phakic intraocular lens implant to correct presbyopia].
abstract: BACKGROUND
  Presbyopic surgery is considered as the new frontier in refractive surgery. Different solutions are proposed: myopization of one eye, insertion of an accommodative crystalline lens, scleral surgery, the effects of which are still unknown, and finally multifocal phakic implants. We therefore decided to undertake a prospective study under the Huriet law to determine its efficacy and specify the conditions required for an anterior chamber multifocal phakic implant.
  
  
  METHODS
  Fifty-five eyes of 33 patients received an anterior chamber foldable multifocal phakic implant. Twenty-one females and 12 males underwent surgery. Initial refraction was between -5D and +5D. The implant's single addition was +2.50. Recuperating a distant uncorrected visual acuity of 0.6 or better and near uncorrected vision of Parinaud 3 or better can be considered a very good postoperative result.
  
  
  RESULTS
  Average follow-up was 42.6+/-18 weeks. Mean postoperative refraction was -0.12+/-0.51 D. Mean postoperative uncorrected visual acuity was 0.78+/-0.20. Postoperative uncorrected visual acuity was Parinaud 2.3+/-0.6. Eighty-four percent of eyes operated on recuperated 0.6 or better without correction and Parinaud 3 or better without correction. Lenses in four eyes were explanted for different reasons, essentially optical, and no severe anatomical complications were observed.
  
  
  CONCLUSIONS
  Placing an anterior chamber multifocal phakic implant to correct presbyopia is an effective technique with good predictability and has the advantage of being reversible in case of intolerance, optical parasite effects or undesired complications. Considering the particularity of this surgery, it is imperative to respect very strict inclusion criteria: anterior chamber depth equal to or above 3.1 mm, open angle, endothelial cell count equal to or above 2000 cells/mm2, absence of an incipient cataract or the slightest evidence of macular alteration.
authors.affiliation: Clinique Monticelli, 88, rue du Commandant Rolland, 13008 Marseille. g.baik.opht@wanadoo.fr
authors.forename: G
authors.initials: G
authors.lastname: Baikoff
authors.forename: G
authors.initials: G
authors.lastname: Matach
authors.forename: A
authors.initials: A
authors.lastname: Fontaine
authors.forename: C
authors.initials: C
authors.lastname: Ferraz
authors.forename: C
authors.initials: C
authors.lastname: Spera
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular; D008297:Male; D009798:Ocular Hypertension / Q000209:etiology; D018579:Patient Selection; D019904:Polymethyl Methacrylate; D011183:Postoperative Complications; D011305:Presbyopia / Q000601:surgery*; D011446:Prospective Studies; D012029:Refraction, Ocular; D013997:Time Factors; D016896:Treatment Outcome; D014792:Visual Acuity
chemical_list: D019904:Polymethyl Methacrylate