Pseudoaccommodation: BioComFold versus a foldable silicone intraocular lens.

PURPOSE To assess the degree of pseudoaccommodation amplitude correlated with shifts along the anteroposterior axis of the BioComFold foldable intraocular lens (IOL). SETTING Department of Ophthalmology, Hôtel-Dieu Hospital, Paris, France. METHODS This prospective study comprised 30 eyes of 30 patients operated on consecutively for cataract by phacoemulsification and in-the-bag implantation of a BioComFold (15 patients) or a foldable control (15 patients) IOL. The BioComFold IOL has a peripheral bulging ring that pushes the optic forward during the effort to accommodate, creating a zoom effect. Pseudoaccommodation amplitude was evaluated using the blurring of controlled vision by adding spheres, with the best correction for distance vision in place. Pupil diameter was measured with a Goldmann campimeter under constant illumination. Anterior chamber depth was determined by A-scan (Paxial, Biophysic Medical) 30 minutes after cyclopentolate 1% was instilled and again 30 minutes after pilocarpine 2% was instilled. RESULTS The difference in pseudoaccommodation amplitude and pupil diameter between the 2 groups was not statistically significant (P = .6737 and P = .4014, respectively). The IOL's forward shifts from maximal ciliary relaxation to maximal ciliary contraction were significantly greater in the BioComFold group (P = .0215). CONCLUSION The design of the BioComFold IOL allowed greater forward optic shifts along the anteroposterior axis during the effort to accommodate. Nevertheless, this shift was not correlated with a significantly greater pseudoaccommodation amplitude.