Single-optic accommodating lens performs well at distance and intermediate, has limitations at near

Uday Devgan

ABU DHABI — An analysis of more than 4,000 cases from 130 surgeons entered into the SurgiVision DataLink database showed that the Crystalens AO single-optic accommodating IOL does well at distance and intermediate with limited effects at near.

"The eyes were all normal eyes. Those with previous LASIK, preoperative pathology, extreme axial lengths or [posterior capsule opacification] were excluded from the analysis," Uday Devgan, MD, said at the World Ophthalmology Congress here.

Mean residual manifest refraction spherical equivalent with the Crystalens AO (Bausch + Lomb) at 6 months was 0.2 D; 69% of eyes were between ±0.5 D of intended correction and 91% were within ±1 D. Mean distance vision was stable around 20/30 between 1 week and 6 months, intermediate was 20/25, and near was J3.

"Near vision is the weak point of this lens," Dr. Devgan said. "From my own experience, no more than 1.5 D of pseudoaccommodation is obtained."

Spectacle independence for distance was achieved by 87% of patients, while for reading only 31% never used glasses.

"Individual response at near depends on the pupil, on the lighting and on [higher-order aberrations]. In my hands I target one eye for plano and the other eye for -1 D, so to increase reading ability with a little bit of monovision," Dr. Devgan said. Visual quality is very good with this lens, he said, and significantly better than the previous HD model and multifocal IOLs.

Disclosure: Dr. Devgan is a consultant for Bausch + Lomb.