Visual outcomes after accommodating intraocular lens implantation

Macsai, Marian S.; Padnick‐Silver, Lissa; Fontes, Bruno Machado

doi:10.1016/j.jcrs.2006.01.027

Cited by 51 publications

(32 citation statements)

References 33 publications

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“…If 19 and the other was an experience report 20 ; 1 study by Claoué et al 21 and 1 study by Macsai et al 22 because they reported only uncorrected visual acuity data.…”

Section: Methodsmentioning

confidence: 99%

Meta-analysis of accommodating intraocular lenses

Findl¹,

Leydolt²

2007

Journal of Cataract and Refractive Surgery

102

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Accommodating intraocular lenses (IOLs) based on the concept of optic shift were introduced to restore accommodation after cataract surgery. Currently, 3 types of accommodating IOLs are commercially available: 1CU (HumanOptics), BioComFold (Morcher), and AT-45 Crystalens (eyeonics, Inc.). We present a meta-analysis of the peer-reviewed data from studies of these IOLs that use optic-shift measurements and visual acuity as the main outcome measures. In the 6 randomized controlled studies, 5 of which studied the 1CU IOL, the visual acuity results showed moderate to no improvement in near visual acuity compared with control IOLs and a statistically significant but small and inter-patient variable anterior shift of the IOL optic after pilocarpine stimulation. More clinical trials with randomized, controlled, and patient- and examiner-masked study designs that follow the guidelines of evidence-based medicine are needed to prove a benefit of accommodating focus-shift IOLs.

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“…If 19 and the other was an experience report 20 ; 1 study by Claoué et al 21 and 1 study by Macsai et al 22 because they reported only uncorrected visual acuity data.…”

Section: Methodsmentioning

confidence: 99%

Meta-analysis of accommodating intraocular lenses

Findl¹,

Leydolt²

2007

Journal of Cataract and Refractive Surgery

102

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“…They also have an application in cosmetics, as well as, they are used for eye protection and healing of corneal lesions 14 . Thus there are PMMA based rigid lenses, soft lenses made of gel like plastic biomaterials and rigid gas permeable(RGP) lenses, constituted of hydrophobic plastic polymeric materials, used in treatment of presbyopia and severe astigmatism.…”

Section: Fig6: Titanium Based Dental Implant Ocular Lensesmentioning

confidence: 99%

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2016

IJPSR

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“…The ability of the Crystalens HD to move forwards enables pseudophakic accommodation; this has been confirmed in several scientific studies using objective and subjective methods (see Figure 4). [1][2][3][4] Also according to the literature, the polyimide material of the haptics causes the IOL to grow quickly and firmly together with the capsular bag. For undisturbed and complete growth, it is important that the patient does not accommodate during the first 10 days after implantation.…”

Section: Mechanism Of Action Of the 'Accommodative' Crystalens Hdmentioning

confidence: 99%

Results Nine Months After Implantation of Crystalens HD

Tomalla¹

2011

European Ophthalmic Review

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Concerning this IOL-type, one can see a continuous improvement and further development concerning the design and refractive possibilities. In addition to treating cataracts, the Crystalens HD can be used to correct myopia, hyperopia and slight astigmatism up to 0.75D. The Crystalens HD is 3μm thicker in the middle of the optic than at the periphery. This additional thickness shortens the spherical radius and adds negative spherical aberration to the mid-peripheral zone of the optic. The negative spherical aberration influences the correction of presbyopia. The 5mm optic of the Crystalens HD is made of silicone, with a refractive index (RI) of 1.427 (see Figure 1). The rigid haptics are made of polyimide. The Crystalens HD is available in the range of 10.0-30.0D in 0.5D steps. Between 18.0 and 22.0D -the major diopters -it is available in 0.25D steps. Because it is a refractive IOL, the surgeon can offer the best possible correction with this range. Patient SelectionThe Crystalens HD can be implanted in eyes with cataract, presbyopia, myopia, hyperopia or astigmatism up to 0.75D. Implantation of this IOL type is not recommended in eyes with very wide pupils or with a ciliary body or capsular bag that is not intact, and in eyes that have undergone previous operations. ImplantationThe surgery/implantation differs clearly from standard cataract surgery:• When placing the Crystalens HD into the injector, attention must be paid to the correct direction of implantation of the IOL. This can be verified by noting the different ends of the haptics.• The round right haptic, which is a little bit larger, must be positioned accurately when placing the IOL into the injector.• The IOL must be implanted in the capsular bag. During surgery, it is important to ensure that the zonula fibres remain intact.• The capsulorhexis must always be larger than the optic of the IOL; that is, a 6mm capsulorhexis must be created for a 5mm IOL optic.The anterior capsular bag must be placed clearly outside the optic (see Figure 2).• The silicone optic is very soft and the polyimide haptics are rigid and inflexible, so the Crystalens HD is difficult to position in the capsular bag, especially in eyes with narrow pupils. It is recommended to position the injector with the IOL through the middle of the pupil into the capsular bag and then inject it slowly.• The IOL must be rotated at least 180° until it fits perfectly. Afterwards, the cortex and the ophthalmic viscosurgical device must be thoroughly removed from behind the optic (see Figure 3). Mechanism of Action of the 'Accommodative' Crystalens HDAccording to the literature, the natural movement of the ciliary muscle is used for accommodation. The ability of the Crystalens HD to move forwards enables pseudophakic accommodation; this has been confirmed in several scientific studies using objective and subjective methods (see Figure 4). [1][2][3][4] Also according to the literature, the polyimide material of the haptics causes the IOL to grow quickly and firmly together with the capsular bag. For ...

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Visual outcomes after accommodating intraocular lens implantation

Cited by 51 publications

References 33 publications

Meta-analysis of accommodating intraocular lenses

Meta-analysis of accommodating intraocular lenses

Untitled

Results Nine Months After Implantation of Crystalens HD

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