Analysis of Accommodative Performance of a New Accommodative Intraocular Lens.

Abstract

To compare objective and subjective accommodation and visual acuities with a new accommodative intraocular lens (IOL) (Lumina; AkkoLens Clinical BV, Rijswijk, The Netherlands) with a monofocal IOL and young phakic eyes. In this prospective, randomized controlled clinical investigation, patients aged 51 to 85 years with symptomatic cataract were enrolled in the study. A total of 25 eyes were implanted with the accommodative IOL and 18 eyes received the monofocal Acrysof SA60AT IOL (Alcon Laboratories, Inc., Fort Worth, TX). Each group included 4 bilateral patients. An additional 20 phakic eyes of young patients aged 19 to 29 years were used to assess the restoration of accommodation. Subjective and objective accommodative amplitudes were evaluated by defocus curves and the WAM-5500 open-field Auto Ref/Keratometer (Grand Seiko, Tokyo, Japan), respectively. The 1-year postoperative examination showed significantly better visual acuities with the accommodative IOL compared to the monofocal IOL, over a defocus range of -0.50 to -5.00 diopters (D) (P < 10-5), and revealed more than 50% of the visual acuities of the young phakic eyes at up to -3.50 D defocus. The depth of focus of the accommodative group exceeded that of the monofocal group by 2.52 ± 0.03 D in a visual acuity range of 0.3 to 0.8 (decimal) (20/63 to 20/25 Snellen). Compared with the monofocal IOL, the accommodative IOL resulted in a similar uncorrected distance visual acuity of 0.99 ± 0.12 (20/20 Snellen) (P > .79) and a significantly better uncorrected near visual acuity of 0.91 ± 0.11 (20/22 Snellen) (P < 2.7 × 10-6). A significant correlation of 0.51 (P < 1.3 × 10-7) was found between the objective and subjective accommodative amplitudes with the accommodative IOL. Eyes implanted with the accommodative IOL showed similar amounts of objective and subjective accommodation. [J Refract Surg. 2018;34(2):78-83.].