Visual outcomes after accommodating intraocular lens implantation

Visual outcomes after accommodating intraocular lens implantation

Author Macsai, M. S. Google Scholar
Padnick-Silver, L. Google Scholar
Fontes, B. M. Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Northwestern Univ
Evanston NW Healthcare
Abstract PURPOSE: To evaluate and compare the visual outcomes and accommodative amplitude in cataract patients after implantation of the Crystalens intraocular lens (100 (Eyeonics) versus standard monofocal IOLs.SETTING: Ten clinics in a nationwide multicenter study in the United States.METHODS: A multicenter comparative interventional case series with masked randomized postoperative examination of 224 eyes of 112 patients was performed by a single observer. Patients were divided into 2 groups (56 patients; 112 eyes each) depending on which IOL was implanted (Crystalens or monofocal). Accommodation was measured using 1 objective (dynamic retinoscopy) and 2 subjective methods (defocus and near point of accommodation). Visual acuity measurements were performed under the same conditions with standard visual acuity charts.RESULTS: Uncorrected monocular near vision was significantly better in the Crystalens group than in the standard monofocal group, with 101 of 112 eyes (90%) and 17 of 112 (15%), respectfully, reading J3 or better postoperatively. All 56 Crystalens patients had a binocular uncorrected near visual acuity of J3 or better compared with 16 of 56 (29%) standard monofocal patients. the mean postoperative monocular (0.85 +/- 0.30 [SD] versus 0.70 +/- 0.19, P<.01) and binocular (1.16 +/- 0.17 versus 1.01 +/- 0.14, P<.01) distance uncorrected visual acuities were also better in the Crystalens group than in the control group. All patients in the study achieved a corrected distance visual acuity of 20/20 or better. Measures of accommodation were significantly higher in Crystalens patients than in the monofocal IOL patients (dynamic retinoscopy 2.42 +/- 0.39 diopters [D] versus 0.91 +/- 0.24 D, P<.01; monocular defocus 1.74 +/- 0.48 D versus 0.75 +/- 0.25 D, P<.01; monocular near point of accommodation 9.5 +/- 3.1 inches versus 34.7 +/- 9.8 inches, P<.01). Perceived accommodation (5.79 D) was significantly greater than the measured accommodation (1.96 to 2.42 D) in Crystalens patients (paired t test, P<.01).CONCLUSIONS: the Crystalens IOL provided better uncorrected near and distance visual outcomes than standard monofocal IOLs in all analyses performed. Patients perceived a greater accommodation than measured. Understanding why this occurred could lead to valuable advances in accommodating IOL technology.
Language English
Date 2006-04-01
Published in Journal of Cataract and Refractive Surgery. New York: Elsevier B.V., v. 32, n. 4, p. 628-633, 2006.
ISSN 0886-3350 (Sherpa/Romeo, impact factor)
Publisher Elsevier B.V.
Extent 628-633
Access rights Closed access
Type Article
Web of Science ID WOS:000237664900026

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