Objective measurement essential in evaluating IOL accommodation

BARCELONA — Objective accommodation measurement is essential to evaluate accommodation restoration by intraocular implants, whereas subjective measurements are grossly unreliable, according to a speaker here.

"Subjective measurements such as defocus curves and push-up tests significantly overestimate the change in dioptric power of accommodative IOLs and do not only measure accommodation," Adrian Glasser, MD, said in a presentation at the European Society of Cataract and Refractive Surgeons meeting. "Other factors, like pupil constriction and individual interpretation of blur, are involved in the response to these tests."

The commercially available Grand Seiko auto refractor and the Tracey iTrace aberrometer are reliable clinical instruments, suitable for objective accommodation measurement, he said.

"By comparing the results of subjective and objective measurements with these devices, we found a significant difference in accommodative amplitude," Dr. Glasser said. "Subjective measurement of accommodation is inappropriate. If we want to evaluate whether accommodative implants accomplish what they claim, namely restoration of accommodation, we should only rely on objective testing."