Comparison of 6-month results of implantation of the 1CU accommodative intraocular lens with conventional intraocular lenses.

OBJECTIVE To evaluate the clinical results of implantation of the new 1CU accommodative intraocular lens (IOL) in cataract patients and to compare results with those of conventional IOLs. DESIGN Nonrandomized comparative trial. PARTICIPANTS Twenty eyes of 20 patients (mean age = 65.8+/-13.3 years) in the 1CU group and 20 eyes of 20 patients (mean age = 67.4+/-11.6 years) in the control group. METHODS All patients underwent phacoemulsification and IOL implantation. The 1CU accommodative lens was used in 20 eyes, and conventional IOLs (polymethyl methacrylate, hydrophilic or hydrophobic acrylate) were used in the control group. Patients were observed prospectively, and 6-month data were analyzed. MAIN OUTCOME MEASURES Accommodative ranges determined by 3 different methods (near point, defocusing, and retinoscopy). Secondary outcome measures were (1) increase of anterior chamber depth after topical application of 1% cyclopentolate eyedrops and (2) distance-corrected near visual acuity with Birkhäuser reading charts at 35 cm. RESULTS We observed a higher accommodative range with all 3 methods (mean = 1.83+/-0.49 vs. 1.16+/-0.27 diopters [D] [near point], 1.85+/-0.43 vs. 0.64+/-0.21 D [defocusing], and 0.98+/-0.55 vs. 0.17+/-0.22 D [retinoscopy]), a larger increase of anterior chamber depth after cyclopentolate eyedrops (mean = 0.42+/-0.18 vs. 0.11+/-0.06 mm), and better distance-corrected near visual acuity (median = 0.4 vs. 0.2) in the 1CU group relative to the control group. All differences between the 2 groups were statistically highly significant (P<0.001). CONCLUSIONS In the present study, the 1CU accommodative IOL showed increased accommodative range and better near visual acuity than a control group with conventional IOLs. Further research is necessary to confirm these results in masked, randomized, prospective studies and to confirm further the accommodative power of this group of new IOLs.

[1]  J Wollensak,et al.  Comparison of a diffractive bifocal and a monofocal intraocular lens , 1996, Journal of cataract and refractive surgery.

[2]  P. Kaufman,et al.  The mechanism of accommodation in primates. , 1999, Ophthalmology.

[3]  J S Cumming,et al.  Clinical evaluation of the model AT-45 silicone accommodating intraocular lens: results of feasibility and the initial phase of a Food and Drug Administration clinical trial. , 2001, Ophthalmology.

[4]  R. H. Keates,et al.  Small‐diameter corneal inlay in presbyopic or pseudophakic patients , 1995, Journal of cataract and refractive surgery.

[5]  T. Oshika,et al.  Relationship between apparent accomodation and corneal multifocality in pseudophakic eyes. , 1999, Ophthalmology.

[6]  L Werner,et al.  Pseudoaccommodation: BioComFold versus a foldable silicone intraocular lens. , 1999, Journal of cataract and refractive surgery.

[7]  Nhung X Nguyen,et al.  Measurement of accommodation after implantation of an accommodating posterior chamber intraocular lens , 2003, Journal of cataract and refractive surgery.

[8]  B. Seitz,et al.  Erste Ergebnisse der Implantation einer neuen, potenziell akkommodierbaren Hinterkammerlinse - eine prospektive Sicherheitsstudie , 2001 .

[9]  C. Huber,et al.  Myopic astigmatism a substitute for accommodation in pseudophakia , 1981, Documenta Ophthalmologica.

[10]  B. Seitz,et al.  Short‐term blood‐aqueous barrier breakdown after implantation of the 1CU accommodative posterior chamber intraocular lens , 2002, Journal of cataract and refractive surgery.

[11]  Nhung X Nguyen,et al.  Implantation of a new accommodative posterior chamber intraocular lens. , 2002, Journal of refractive surgery.

[12]  R. Lindstrom,et al.  Food and Drug Administration study update. One-year results from 671 patients with the 3M multifocal intraocular lens. , 1993, Ophthalmology.

[13]  André F. Oliveira,et al.  Benefit of against‐the‐rule astigmatism to uncorrected near acuity , 1997, Journal of cataract and refractive surgery.

[14]  M Nakazawa,et al.  Apparent accommodation in pseudophakic eyes after implantation of posterior chamber intraocular lenses. , 1983, American journal of ophthalmology.

[15]  S. Mathews,et al.  Scleral expansion surgery does not restore accommodation in human presbyopia. , 1999, Ophthalmology.

[16]  J C Horton,et al.  PERSPECTIVES IN REFRACTION , 2004 .

[17]  R. Weale,et al.  Presbyopia toward the end of the 20th century. , 1989, Survey of ophthalmology.

[18]  M Nakazawa,et al.  Apparent accommodation in pseudophakic eyes after implantation of posterior chamber intraocular lenses: optical analysis. , 1984, Investigative ophthalmology & visual science.

[19]  R. Steinert,et al.  A prospective comparative study of the AMO ARRAY zonal-progressive multifocal silicone intraocular lens and a monofocal intraocular lens. , 1999, Ophthalmology.