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Accommodating IOL enhances near, distance VA in European study
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CHICAGO — An accommodating IOL significantly improved visual acuity safely, a clinician said here.
Ioannis G. Pallikaris, MD, presented preliminary European results of the Crystalens HD accommodating IOL (Bausch + Lomb) at the Refractive Subspecialty Day preceding the joint meeting of the American Academy of Ophthalmology and the Middle East Africa Council of Ophthalmology.
"I think we are ready to adopt this technology and the design of this lens," Dr. Pallikaris said.
The prospective study looked at 26 eyes of 15 patients who were implanted with the lens. The mean follow-up was 8.71 months.
Study results showed that logMAR uncorrected distance visual acuity improved from 0.41±0.21 before surgery to 0.70±0.19 at final follow-up.
Corrected distance VA improved from 0.66±0.28 to 0.87±0.15. In addition, 70% of patients had near J3 or better, Dr. Pallikaris said. For intermediate vision, 80% of patients saw J1.
A subgroup analysis of four patients was undertaken to compare sulcus implantation and in-the-bag implantation. Mean postoperative logMAR CDVA was 0.04 in the sulcus implantation group and 0.03 in the non-sulcus implantation group (both Snellen equivalent 20/22).
Mean logMAR UDVA was 0.19 (Snellen equivalent 20/31) in the sulcus implantation group and 0.16 (Snellen equivalent 20/29) in the non-sulcus implantation group, Dr. Pallikaris said.
- Disclosure: Dr. Pallikaris has no direct financial interest in the products discussed in this article, nor is he a paid consultant for any companies mentioned.
We still are not aware of most of what happens with this generation of accommodative single optic IOLs, which explains the variability in the outcomes. The mechanisms involve less the shift in the lens position and more the change in the optical performance of the lens, in concordance with pupil size. However, positive outcomes are expected if properly indicated and used.
If clinical practice is reassured in the use of this lens, Crystalens HD accommodating IOL (Bausch + Lomb), the surgeons can get a better outcome than with a regular monofocal lens, with the advantage over the multifocals of not inducing photic phenomena, especially glare and halos. Today’s models available of the HD are consistently offering a pseudoaccommodation near vision improvement of about one or more diopters which, on a binocular basis, is enough for excellent intermediate vision performance. This lens is indicated in those patients in whom far vision should be optimal with no photic disturbances with intermediate vision and some improvement in near with spectacle use for particularly delicate near-vision activities.
— Jorge L. Alió, MD, PhD
Alicante, Spain
Disclosure: Dr. Alio is a consultant for Bausch + Lomb Surgical.