Evaluierung der Wertigkeit objektiver und subjektiver Verfahren zur Messung von pseudophaker Akkommodation

Abstract

The aim of this study was to compare the validity and plausibility of various subjective and objective measurement methods for evaluation of pseudophakic accommodation. Eye Clinic Bellevue, Kiel, Germany. A total of 21 patients were examined over an average period of 34 months (range 12-51 months) after implantation of a potentially accommodative, model 1CU intraocular lens (IOL, HumanOptics, Germany). The following subjective measurements were taken: near point measurement with the accommodometer (Clement Clarke, Harlow, UK), defocus curve and near visual acuity with far and near reading charts. The IOLMaster (Carl Zeiss Meditec, Germany), ACMaster (Carl Zeiss Meditec, Germany) and Shin-Nippon K 5001 AR (Shin-Nippon, Japan) were employed as objective measurement devices. With this devices information is obtained about the anterior chamber depth (ACD, preoperative and postoperative), the movement of the IOL and the refractive change of eyes during the accommodative process. Depending on the method utilized there were large variations of the examined IOL in relation to the extent of the measured accommodative effects in their entirety with the objective as well as the subjective measurement method. A differentiation of pseudophakic accommodation and pseudophakic pseudoaccommodation is not possible with the conventional measurement methods applied and examined in this study. Only the ACMaster is an objective method for measurement of the axial shift of an IOL. However, subjective measurement methods can only record the total of both accommodation portions but do not allow any scientifically-founded statement about the functional principle of a potentially accommodative IOL.