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Accommodative ability returns over time after lens implantation

Am J Ophthalmol. 2008;146(5):674-678.

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An implantable Collamer lens may cause some loss of accommodation after surgery, but long-term outcomes suggest that the implanted eye recovers accommodative ability over time.

The Visian ICL (STAAR Surgical) is used by some surgeons for correcting ametropia because, unlike refractive lens exchange, the crystalline lens is not affected. However, because the lens is implanted in the ciliary sulcus, accommodative function may be compromised after surgery.

In 69 eyes of 40 patients with refractive error ranging from –3.25 D to –22.75 D who were implanted with the ICL, mean accommodative ability, measured with an accommodometer, was 6.36 ± 3.94 D preoperatively, compared with 4.89 ± 2.72 D on day 1 after surgery.

However, accommodative ability improved with time: 4.98 ± 2.67 D on day 3, 5.16 ± 2.72 D on day 6 and 5.72 ± 2.85 D at 12 months after surgery.

The effect on accommodative ability "may be attributed to transient dysfunction of the ciliary muscles by ICL fixation to the sulcus even if the crystalline lens remained untouched," the study authors said.