Pseudo-accommodation in non-amblyopic children after bilateral cataract surgery and implantation with a monofocal intraocular lens: prevalence and possible mechanisms

Dénier, Charlotte; Dureau, P.; Edelson, C.; Barjol, Amandine; Caputo, G.

doi:10.1007/s00417-016-3526-4

Cited by 5 publications

(4 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…16 Using a ray-tracing equation, they suggested that when the IOL optic moves forward by 1 mm, the pseudoaccommodation is 0.8 D in long eyes and 2.3 D in short eyes. 16 They also found that the effect of IOL shift on the amplitude of accommodation depends 23 Atchison also proposed an equation for pseudoaccommodation which depended on 4 parameters: range of IOL movement, IOL position, keratometry, and AL. 24 However, other studies have found some correlation between preoperative AL and pseudoaccommodation through IOL movement with in-the-bag IOL fixation.…”

Section: Discussionmentioning

confidence: 99%

“…In children, Denier et al found larger IOL power and smaller AL in the group with pseudoaccommodation. 23 Atchison also proposed an equation for pseudoaccommodation which depended on 4 parameters: range of IOL movement, IOL position, keratometry, and AL. 24 However, other studies have found some correlation between preoperative AL and pseudoaccommodation through IOL movement with in-the-bag IOL fixation.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Incidence and factors for pseudoaccommodation after monofocal lens implantation: the Monofocal Extended Range of Vision study

Nanavaty,

Mukhija,

Ashena

et al. 2023

J Cataract Refract Surg

View full text Add to dashboard Cite

Purpose: To screen the patients with monofocal intraocular lens (IOL) for incidence of unaided 20/40 and J5 for distance and near (pseudoaccommodation) and to find factors for pseudoaccommodation. Settings: University Hospitals Sussex NHS Foundation Trust, UK. Design: Prospective study Methods: This was a single-eye study (Clinicaltrials.gov: NCT04011696). At 3-9 months, refraction, uncorrected & best-corrected distance & uncorrected near LogMAR acuity, spherical equivalent (SEQ), mesopic pupil size (PS), total eye spherical (Z4 0), vertical coma (Z3 -1) aberrations, reading speed and smallest print size were assessed. Refractive astigmatism (RA) was classified as against-the-rule, with-the-rule, oblique and no astigmatism. Data on preoperative axial length (preopAL) and anterior chamber depth (preopACD) were collected. Results: 29 patients (9.6%, 95% CI: 6.5-13.5) had pseudoaccommodation. In cases vs. controls, median SEQ, PS, total Z4 0, Z3 -1, reading speed, smallest print size, preopACD, preopAL were: -0.39 vs. 0.0Diopters; 3.62 vs. 4.10mm; 0.01 vs. 0.02µm; 0.018 vs. 0.022µm; 106 vs. 133wpm (words per minute); 0.30 vs. 0.50LogMAR; 2.94 vs. 3.13mm, 23.4 vs. 23.7mm, respectively. RA was not different between the groups. Univariate analysis revealed preopACD (OR=0.38, 95% CI=0.16-0.94, p=0.04), SEQ (OR=0.61, 95% CI=0.42-0.88, p=0.01), total Z4 0 (OR=0.0003, 95% CI=0.00-0.39, p=0.03) and PS (OR=0.39, 95% CI=0.22-0.69, p<0.041) to be significant. Whereas multivariate logistic regression identified: preopAL (OR=0.62, 95% CI=0.42-0.91, p=0.02), SEQ (OR=0.49, 95% CI=0.31-0.78, p=0.01), Z4 0 (OR=0.00, 95% CI=0.0-0.01, p=0.01) and PS (OR=0.41, 95% CI=0.23-0.75, p=0.01) to be significant. Conclusions: A combination of low myopic SEQ, lower Z4 0, shorter preop AL, and smaller PS increases the chances of pseudoaccommodation.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Incidence and factors for pseudoaccommodation after monofocal lens implantation: the Monofocal Extended Range of Vision study

Nanavaty,

Mukhija,

Ashena

et al. 2023

J Cataract Refract Surg

View full text Add to dashboard Cite

show abstract

“…Moreover, it has been reported that pseudoaccomodation with a monofocal IOL is more prevalent in pseudophakic non-amblyopic children than adults (90% vs 7%). 35 This phenomenon is attributable to the smaller axial length, higher IOL power, corneal higher-order aberrations and maximized IOL shift in children as compared to adults. This at least partly explains the reluctance of most surgeons to shift from monofocal to multifocal IOLs in children.…”

Section: Multifocal Intraocular Lensesmentioning

confidence: 99%

“…Compliance issues with spectacles is another concern, more so in syndromic children. 4,5 In recent years, multifocal intraocular lenses (IOLs) have been attempted in the pediatric population in an attempt to restore the accommodation and achieve better stereopsis; however, the associated challenges like IOL power calculation, surgical complications and need for re-surgery have not been studied in detail. 6,7 The next major challenge of pediatric cataract surgery is confronting the accompanying astigmatism.…”

Section: Introductionmentioning

confidence: 99%

Premium intraocular lenses in children

Asif

Raj

Kalra

et al. 2022

European Journal of Ophthalmology

View full text Add to dashboard Cite

Multifocal and toric intraocular lenses (IOLs) or the so-called premium IOLs are currently widely used in adult patients as a one-step refractive solution following cataract surgery. However, the decision to implant a premium IOL in a pediatric patient involves multiple factors affecting the child’s visual development and is associated with several dilemmas and surgical challenges. The purpose of this review is to summarize these factors and analyse the influence of each of them on the visual outcomes following premium IOL implantation. A review of literature was conducted using the relevant keywords from various databases until 31st January 2022. All pertinent studies with multifocal or toric IOL implantation in children were reviewed, and relevant articles were studied in detail for age, IOL power calculation, visual outcomes (refractive outcomes, contrast sensitivity and stereopsis) and complications such as dysphotic phenomena and others. A total of 17 relevant studies (10 case series/interventional studies and 7 case reports) on the subject were included. All studies showed a favourable refractive outcome; however, the data available was significantly less. Studies with earlier models of multifocal IOLs showed a higher incidence of IOL decentration and posterior capsule opacification; however, more recent studies with newer IOL models showed much better safety profiles. Toric IOLs showed promising results in all the studies evaluated. Premium IOLs have shown promising results in the pediatric age group. However, their long-term outcomes specifically concerning refractive shift, capsular contraction and role in the management of amblyopia needs to be explored further.

show abstract