Accommodating IOLs ‘still work’ at 2 years postop

SAN FRANCISCO — Patient motivation is a key factor in the success of accommodating IOLs, according to a surgeon who has been implanting the lenses for more than 2 years.

“The magnitude of accommodative power is greater if the patient is motivated to use it,” said Tobias Neuhann, MD. He described his long-term experience with the C&C Vision CrystaLens here at the American Society of Cataract and Refractive Surgery meeting.

“The question is, do these lenses still work at 2 years postop, and the answer is Yes,” he said.

Dr. Neuhann began implanting the C&C Vision lens in July 2000, and he now has 14 patients with more than 19 months’ follow-up. Accommodative amplitude in these patients ranges from about 1.5 D to 3 D at most recent follow-up, he said.

Initially, Dr. Neuhann said, patients tend to have a high degree of accommodation, but at 3 months the amplitude begins to decrease somewhat. He said when he first noted this phenomenon, he was disappointed and felt the accommodative IOL was failing. In response, Dr. Neuhann said he prescribed the standard 2.5 D spectacle add for these patients, and at 1 year their accommodative performance was relatively poor.

But he said he has since discovered that a smaller degree of spectacle add – or none at all – is enough for most of his accommodative IOL patients to see well at distance and near.

“If patients are motivated to use their accommodation, they will use it,” Dr. Neuhann said. “The add required for most patients to achieve Jaeger 1 is about 1 D to 1.5 D.”

Dr. Neuhann said that at 2 years, binocular near vision of J2 can be achieved by almost 100% of patients with their distance correction in place.

“Our results at 2 years are much better than at 1 year,” he said.