Lens refilling to restore accommodation

Abstract

The ultimate goal of cataract surgery, besides the restoration of distance visual acuity, is the restoration of accommodation. Lens refilling with an injectable polymer has the potential of restoring accommodation following cataract surgery. Two main difficulties have hampered the success of lens refilling strategies in the past. First was leakage of the injectable material from the capsular bag and second was after-cataract formation resulting in loss of elasticity and opacification of the lens-bag complex. Recently, simplified and highly reproducible lens refilling procedures have been introduced with a potential for clinical application to restore accommodation. We present a summary of the existing methods of lens refilling for restoration of accommodation and some obstacles to clinical application that remain.

Preoperative and postoperative size and movements of the lens capsular bag: Ultrasound biomicroscopy analysis

“…[1][2][3] The early work helped us understand and evaluate differences between pseudoaccommodation and real accommodation as well as the importance of the anatomic prerequisites for accommodation.…”

Influence of a Modified Nd:YAG Laser Treatment Outside the Visual Axis on the Morphology of Elschnig Pearls

“…If it were possible to keep the posterior capsule intact, it might be possible to realize the functional properties of the capsule such as its elasticity and function as separating the posterior from the anterior segment, which would allow restoration of accommodation such as lens refilling, or 'Phakoersatz' , where PCO appears to be the main limiting factor [21]. If we could use a laser that could polish the posterior capsule and eliminate Elschnig pearls with a pressure wave without opening the capsule, it would be possible to tackle the main problem for restoration of accommodation.…”

Glue microapplicator for perforating injuries of the lens capsule

“…8 Fibrinogen-based sealing of capsule incisions may prove helpful after capsule bag refilling with artificial lens matter, providing the latter has not interfered with the survival of the lens epithelium. [9][10][11] Laser welding of capsule patches has been tested in vitro. 12 Phase separation inhibitors or vitamin E proved helpful in the prevention or reduction of lens opacities in animal experiments.…”