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Accommodative stimuli spur slight anterior movement of optic-shift IOL
J Refract Surg. 2009;25(5):416-420.
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An optic-shift IOL produced low accommodation associated with pharmacologically induced shift and optically induced shift.
The study authors assessed accommodative effect of the 1CU optic-shift IOL (HumanOptics), with accommodation induced by an optical stimulus and pilocarpine 2%.
The 1CU lens is designed to move anteriorly under an accommodative stimulus, reducing focal distance within the eye and enhancing near vision, the authors said.
The study included 15 eyes of nine patients who underwent phacoemulsification and implantation of the 1CU lens. Mean patient age was 71.1 years.
The authors used the ACMaster (Carl Zeiss Meditec), a laser-interferometric biometry device, to measure change in IOL position and accommodative effect. The IOLMaster (Zeiss) was used to perform preoperative biometry and keratometry. Implanted IOLs ranged in power from 16 D to 25 D.
Under optical-induced accommodation, mean anterior movement of the 1CU lens was 5 ± 14 µm. Under pharmacological stimulation, mean anterior movement of the lens was 93 ± 162 µm. Induction produced a maximum accommodative effect of 0.5 D.
“This relatively small accommodative effect of the 1CU is in agreement with other studies,” the authors said. “Summarizing the results, it can be stated that little movement of the 1CU occurs under optical stimulation and slight movement is noted under pilocarpine stimulation. To clarify the clinically observed near vision results, other explanations must be considered.”
This study is interesting in that it is evaluating the accommodative amplitude of the HumanOptics 1CU accommodative IOL by looking at optically induced and miotic-induced anterior shift of the lens and correlating it to refractive change. The study found that in both instances, there was only about 0.5 D of myopia induced by the shift on average. This did not seem to change with the patient’s age or axial length. Therefore, the take-home message of this study is that the movement of the IOL does not correlate with the clinically observed near vision results, and thus, further study into the mechanism of action of this IOL is warranted.
– Rosa Braga-Mele, MD, FRCSC
OSN Cataract
Surgery Section Editor