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Accommodating IOL boosts near, distance visual acuity in pseudophakic presbyopic eyes
J Cataract Refract Surg. 2010;36(7):1167-1172.
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An accommodating IOL yielded visual acuity success in pseudophakic presbyopic eyes, a study showed.
"Initial experience indicates that the accommodating IOL provides functional near and distance visual acuity for daily tasks," the study authors said. "Surgeon experience and refinement of IOL calculations are required to improve outcomes."
The prospective study included 25 eyes of 23 patients that underwent phacoemulsification and implantation of a Crystalens AT-45 accommodating IOL (Bausch + Lomb). Mean IOL power was 21.8 D (range: 19 D to 24 D).
Investigators assessed uncorrected and corrected near and distance visual acuities, manifest refraction spherical equivalent and patient satisfaction.
Study data showed that at 6 months, 23 eyes had uncorrected distance visual acuity of 6/12 or better. All eyes had corrected distance visual acuity of 6/12 or better.
The difference in corrected and uncorrected distance visual acuity from 1 month to 6 months postop was statistically insignificant.
Mean distance-corrected near visual acuity was J5 at 1 month and 6 months. From 1 month onward, more than 60% of eyes had distance-corrected near visual acuity of J3 or better.
Data showed a statistically significant difference between preoperative and postoperative distance-corrected near visual acuity at 6 months (P = .021), the authors said.
The authors performed a prospective, uncontrolled study of near and distance vision with the first generation Crystalens 4.5. They used a near point of 35 cm and did not record intermediate vision, which is functionally important. They found uncorrected near vision of J3 or better in 72% of eyes at 6 months, similar to the 78% reported in larger studies of near vision measured at 40 cm with Crystalens 4.5. In comparison, the latest, fifth generation, aspheric, aberration-free Crystalens — the Crystalens AO — shows 94% uncorrected vision of J3 or better, and distance corrected near of J3 in 91% (n=194). Intermediate vision at 80 cm was J3 in 100% of eyes. These data reflect an iterative improvement in near vision with advancing Crystalens models, while maintaining excellent intermediate and distance vision.
– Jay S. Pepose, MD, PhD
Director, Pepose
Vision Institute, St. Louis
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