This article is more than 5 years old. Information may no longer be current.
True accommodation remains holy grail of cataract surgery
Click Here to Manage Email Alerts
SAN FRANCISCO — Advances in IOL development enable safe and minimally invasive surgery with positive visual outcomes, a guest lecturer said here.
Nick Mamalis, MD, traced the "long, strange trip" of IOL development as he gave the Binkhorst Lecture during the opening ceremonies at the American Society of Cataract and Refractive Surgery meeting.
Nick Mamalis
Providing true accommodation is the main challenge faced by cataract surgeons today, Mamalis said.
"Cataract surgery is a very successful procedure ... but we still lack a good way of giving people both near and distance vision," he said. "We really need a way to look at accommodation."
Sir Harold Ridley ushered in modern cataract surgery with the invention of the IOL in the early 1950s. Treating Royal Air Force pilots with pieces of shattered cockpits in their eyes, Ridley found that the pilots’ eyes had a tolerance for polymethyl methacrylate (PMMA), of which the cockpits were made. This inspired Ridley to fashion and insert artificial lenses made of PMMA, Mamalis said.
IOL technology has advanced steadily since Charles Kelman, MD, and colleagues pioneered phacoemulsification in the early 1970s. Improved phacoemulsification techniques have enhanced intraoperative safety, and small incisions have enabled the insertion of foldable IOLs, Mamalis said.
New and emerging IOL technologies include dual-optic systems such as the Synchrony (Abbott Medical Optics), the NuLens (NuLens Ltd.) and the Elenza (Elenza Inc.).
The Synchrony IOL features anterior and posterior optics that provide near and distance vision. The NuLens is a fluid-driven IOL that works in tandem with motion in the ciliary sulcus. The Elenza features a battery-powered liquid crystal optic.
The future of IOL technology includes the Light Adjustable Lens (Calhoun Vision). Researchers are also developing an injectable IOL that enables natural accommodation, like the human crystalline lens, Mamalis said.
Disclosure: Mamalis has financial relationships with Abbott Medical Optics, Alcon, Allergan, ARC Laser, Anew Optics, Bausch + Lomb, Calhoun Vision, MBI, Nu View, Ophthalmic Innovations International and OptiMedica.