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Biometry tells story of accommodative IOLs, surgeon says
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LISBON, Portugal — Measuring the movement of the IOL optic is the only reliable method of assessing whether an accommodating IOL actually works, according to one presenter here.
Studies that rely on psychophysical measures, such as distance-corrected near visual acuity, to show that accommodating lenses work can be influenced by other variables that can affect the outcome, Oliver Findl, MD, said. He spoke here at the European Society of Cataract and Refractive Surgeons meeting.
Variables including the patient’s pupil size, astigmatism and corneal multifocality, as well as the motivation of patient and examiner, can influence the depth of field and therefore might give the impression that the lens is moving back and forward in the capsular bag.
“If you want to see the optic shifting, why not measure the shift itself so you know if it’s the IOL that’s working, or other factors?” Dr. Findl said.
Dr. Findl and his colleagues evaluated the optic movement of accommodative IOLs using the Carl Zeiss Meditec IOLMaster, which uses noncontact partial coherence interferometry (PCI) to measure structures in the anterior chamber.
Dr. Findl said that PCI allows measurements inside the anterior segment with precision within a range of a few microns.
Using PCI, they found no or little forward movement of the lenses. In addition, the amount of movement they found varied substantially between patients, he said.
“There is a tradeoff between questionable accommodation vs. a definite compromise in bag performance,” Dr. Findl said. “The future might be found in dual optic lenses, which could be promising because they operate under a different principle.”