ESCRS 2026: Real-world aceclidine data show rapid, lasting near vision gains

Maria Soledad Romero, MD, founder and chief medical officer of Precision Eye Care in Baltimore, presented a prospective, single-arm, real-world study of aceclidine ophthalmic solution 1.44% (VIZZ; LENZ Therapeutics) for presbyopia at ESCRS 2026.

The study enrolled patients at Precision Eye Care between August 2025 and January 2026, with assistance from students at Johns Hopkins University. Eligible patients used glasses for near vision only and wanted greater independence from reading glasses; the population included phakic, pseudophakic, and cataract patients, but excluded anyone using multifocal or monovision correction.

What did patients report about onset and duration?

Patients reported a rapid onset of effect, noticing improved near vision within 15 to 30 minutes of instillation, according to Romero. About 60% of patients reported the effect lasting approximately 6 hours, and 85% reported improvement on functional near-vision tasks, such as reading small print, using a computer, or checking a phone, without needing glasses during that window. Only 9 of 61 patients (14.8%) remained on aceclidine at the 3-month follow-up visit. No serious ocular adverse events were reported, including retinal detachment, iritis, persistent visual loss, or treatment-related emergency visits.

Which patients had the best treatment experience?

Overall patient experience scored 8 to 8.4 out of 10, though about 40% of patients reported bothersome adverse effects, primarily dimming, hyperemia, and brow ache or headache. The mean patient age was 57 years (range, 47-78), with diverse representation across gender and race. Romero said patients with darker irises tended to report higher satisfaction, while those with lighter irises and correspondingly smaller pupils noticed more visual adverse effects.

Pseudophakic patients with standard intraocular lens implants and patients with recent-onset presbyopia, who may not be accustomed to wearing reading glasses, also reported greater satisfaction than long-term glasses wearers. Subgroup sizes were small, and no formal statistical analysis was performed. Romero said what surprised her most was both the speed of onset and how open patients were to an alternative to reading glasses.

Reference
1. Romero MS, Han D, Setton M, Tasser I, Lerma M. A real-world outcomes study for aceclidine 1.44% eye drops to manage presbyopia. Presented at: 44th Congress of the European Society of Cataract and Refractive Surgeons; September 11-15, 2026; London, United Kingdom.