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Better tailoring may be needed for accommodating lenses
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ROME — Currently available accommodating IOLs are too large to perform true accommodation movements, a clinician said here.
"We need to abandon the standard-size IOL concept and do better IOL tailoring if we want the lens to move at all," Marina Modesti, MD, said at the meeting of the Italian Society of Cataract and Refractive Surgery.
In her ultrasound biomicroscopy studies of two models of accommodating lenses, she showed that the capsular bag, which is on average 9 mm to 10 mm in diameter preoperatively, is stretched to the full size of the lens after implantation. There is no space between the bag equator and the ciliary ring. Zonular traction is annulled, and the bag and lens are displaced posteriorly.
"There is no way the lens can move forward from this position because it is incarcerated behind the ciliary processes," Dr. Modesti explained.
Until an IOL is designed that fully respects the anatomy and physiology of the capsular bag, true accommodation will not be possible, she said.
- Disclosure: Dr. Modesti has no direct financial interest in the products discussed in this article, nor is she a paid consultant for any companies mentioned.