Purpose: To evaluate the refractive impact of centripetal fragmentation using the miLOOP system for nucleus disassembly, which minimizes lens zonulocapsular instability associated with endocapsular lens manipulation.
Setting: Private practice, Batesville, Indiana, USA.
Design: Retrospective comparative consecutive series.
Methods: Refractive outcomes were compared for consecutive patients who underwent cataract surgery and intraocular lens implantation before and after the introduction of a microinterventional endocapsular nucleus disassembly technique using the miLOOP system. Eyes with a history of previous surgery or ocular comorbidities were excluded. The primary outcome was the median absolute error (MedAE) from the preoperative predicted refraction. Secondary outcomes included corrected (CDVA) and uncorrected distance visual acuity (UDVA) and the proportion of eyes within predicted diopter (D) ranges.
Results: A total of 118 eyes of 79 patients were analyzed, with 69 eyes undergoing conventional nuclear disassembly and 49 eyes receiving the microinterventional technique. The MedAE for eyes using conventional nucleus disassembly vs the microinterventional technique was 0.191 D vs 0.107 D, respectively (P = .002). For CDVA and UDVA, the microinterventional approach resulted in a trend toward a higher proportion of eyes achieving acuities better than 20/30, 20/25, and 20/20 compared with conventional techniques. The microinterventional approach showed a trend toward more eyes achieving less than ±0.25 D and ±0.50 D of prediction error from the predicted diopter range.
Conclusions: Microinterventional nuclear disassembly might improve refractive outcomes by reducing refractive prediction error.