Benefits and barriers of accommodating intraocular lenses

Pepose, Jay S.; Burke, J. P.; Qazi, Mujtaba A.

doi:10.1097/icu.0000000000000323

Cited by 37 publications

(24 citation statements)

References 30 publications

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“…The latter research on possible future advances in 'accommodating' implants is discussed in section 7. In conjunction prevention and/ or treatment of capsular contraction to allow the lens mechanisms to continue to function have been explored (Pepose et al, 2017b). It is noteworthy that the number of peer-reviewed publications on these IOLs has reduced significantly over the last decade and are now generally reviews or evaluations of older IOL designs.…”

Section: 'Accommodating' Iolsmentioning

confidence: 99%

Presbyopia: Effectiveness of correction strategies

Wolffsohn

Davies

2019

Progress in Retinal and Eye Research

231

178

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Presbyopia is a global problem affecting over a billion people worldwide. The prevalence of unmanaged presbyopia is as high as 50% of those over 50 years of age in developing world populations, due to a lack of awareness and accessibility to affordable treatment, and is even as high as 34% in developed countries. Definitions of presbyopia are inconsistent and varied, so we propose a redefinition that states "presbyopia occurs when the physiologically normal age-related reduction in the eye's focusing range reaches a point, when optimally corrected for distance vision, that the clarity of vision at near is insufficient to satisfy an individual's requirements". Strategies for correcting presbyopia include separate optical devices located in front of the visual system (reading glasses) or a change in the direction of gaze to view through optical zones of different optical powers (bifocal, trifocal or progressive addition spectacle lenses), monovision (with contact lenses, intraocular lenses, laser refractive surgery and corneal collagen shrinkage), simultaneous images (with contact lenses, intraocular lenses and corneal inlays), pinhole depth of focus expansion (with intraocular lenses, corneal inlays and pharmaceuticals), crystalline lens softening (with lasers or pharmaceuticals) or restored dynamics (with 'accommodating' intraocular lenses, scleral expansion techniques and ciliary muscle electrostimulation); these strategies may be applied differently to the two eyes to optimise the range of clear focus for an individual's task requirements and minimise adverse visual effects. However, none fully overcome presbyopia in all patients. While the restoration of natural accommodation or an equivalent remains elusive, guidance is given on presbyopic correction evaluation techniques.

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Section: 'Accommodating' Iolsmentioning

confidence: 99%

Presbyopia: Effectiveness of correction strategies

Wolffsohn

Davies

2019

Progress in Retinal and Eye Research

231

178

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“…More recently, single optic 'accommodating' IOLs designed to allow movement along the visual axis by using the action of ciliary muscle have been reported to make mild to moderate improvements in depth of focus post cataract surgery without loss of optical quality when compared with monofocal lenses [6,7]. However, these IOLs are limited by their low and variable amplitude of 'accommodation' and rely on forward translation or induced spherical aberration rather than dynamic changes in refractive index [8]. Small aperture optics is another promising technology in the quest to achieve extended range of focus post cataract surgery and is further discussed below along with an initial clinical evaluation of its performance.…”

Section: Introductionmentioning

confidence: 99%

Small aperture IC-8 intraocular lens in cataract patients: achieving extended depth of focus through small aperture optics

Hooshmand¹,

Allen

Huynh³

et al. 2019

Eye

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Background To investigate visual outcomes following cataract surgery in patients who were implanted monocularly with an extended range of focus IC-8 IOL. Methods A multicentre, non-randomised, retrospective case series of 126 consecutive patients implanted with the IC-8 IOL. Data were collected and pooled from six centres across Australia. Uncorrected distance visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA) at 80 cm and uncorrected near visual acuity (UNVA) at 40 cm were measured in eyes implanted with the IC-8 IOL. Adverse events, spectacle independence, visual symptoms and patient satisfaction were assessed at final follow-up. Results Over 90% of the patients without pre-existing ocular pathology (n = 109) achieved UDVA, UIVA and UNVA of 6/ 12 or better in the IC-8 eye. Binocularly, in this group, 98% achieved UDVA of 6/9, 94% UIVA of 6/12 and 91% UNVA of 6/12 or better. By final follow-up, over 50% of patients reported complete spectacle independence for distance, intermediate and near visual activity, with the remainder only using spectacles for specific tasks such as near-vision hobbies and reading in dim light. Conclusions The IC-8 IOL is capable of providing extended depth of focus following cataract surgery. It allows complete spectacle independence in more than half of the patients implanted with the IC-8 IOL.

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“…An asymmetric capsular contraction causes the plate haptics to vault in opposite directions [ Figure 11 ][ 107 ] inducing astigmatism. [ 107 108 109 110 ] Intraoperative measures to mitigate the risk of Z-syndrome include central capsulorrhexis with adequate coverage of the plate haptics and meticulous cortical material removal. Mild fibrosis may be treated with a Nd YAG laser capsulotomy; more pronounced Z-syndromes may need IOL repositioning or an IOL exchange.…”

Section: Discussionmentioning

confidence: 99%

Correction of presbyopia: An integrated update for the practical surgeon

Balgos

Vargas

Alió

2018

Taiwan J Ophthalmol

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Presbyopia results from loss or insufficiency of the eye's accommodative ability, and clinically manifests as the inability to focus near objects on the retina. It is one of the most common causes of visual impairment worldwide especially in adults of productive or working age. Various means of compensating for the loss of accommodative ability have been devised from optical tools such as spectacles and contact lenses, to topical medications and to surgical procedures. A comprehensive search on journal articles about topical and surgical correction of presbyopia was undertaken. The various techniques for presbyopia correction, as enumerated in these articles, are discussed in this paper with the addition of our personal experience and perspective on the future of these techniques.

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Benefits and barriers of accommodating intraocular lenses

Cited by 37 publications

References 30 publications

Presbyopia: Effectiveness of correction strategies

Presbyopia: Effectiveness of correction strategies

Small aperture IC-8 intraocular lens in cataract patients: achieving extended depth of focus through small aperture optics

Correction of presbyopia: An integrated update for the practical surgeon

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