Akkommodative IOL: Funktionelle Ergebnisse

Pharmacological-induced Haptic Changes and the Accommodative Performance in Patients With the AT-45 Accommodative IOL

PURPOSE

To investigate the accommodative performance of the AT-45 (eyeonics Inc, Aliso Viejo, Calif) using three-dimensional ultrasound biomicroscopy.

METHODS

The AT-45 haptic region was visualized in vivo 1 month after surgery in four patients using an in-house developed three-dimensional ultrasound biomicroscope. Haptic changes, axial shift, and accommodation amplitude were determined under pharmacologically induced accommodation.

RESULTS

The angulation, depending on the accommodation state, could be distinguished and analyzed. In vivo a mean change in haptic angulation of 3.3 +/- 3.3 degrees (range: 0 degrees to 7 degrees) and a mean forward shift of 0.13 +/- 0.08 mm (range: 0.05 to 0.2 mm) were observed for the AT-45 using pharmacologically induced accommodation. A mean accommodative amplitude of 0.44 +/- 0.24 diopters (D) (range: 0.25 to 0.75 D) was found using a Hartinger coincidence refractometer.

CONCLUSIONS

Minimal angulation changes and axial movements of the AT-45 have been demonstrated using pharmacological stimulation and objective measurement methods. The mechanical performance of the AT-45 in these eyes does not appear to provide the range of accommodation necessary for close work.

Potentially Accommodating Intraocular Lenses - An In Vitro and In Vivo Study Using Three-dimensional High-frequency Ultrasound

PURPOSE

To investigate the accommodative performance of new intraocular lenses (IOL) using the advantages of three-dimensional ultrasound biomicroscopy.

METHODS

An in vitro simulation device was designed to study IOL performance using an artificial capsular bag and a stretching device. The haptic region of the Akkommodative 1CU (HumanOptics AG) and CrystaLens AT-45 (Eyeonics Inc) was visualized in vitro in three dimensions, using an in-house developed three-dimensional ultrasound biomicroscope. The in vitro results were used to describe the in vivo situation in four patients with accommodative implants.

RESULTS

The haptic position and angulation in consideration of the accommodation state was distinguished and analyzed. In the simulation model, a maximal angulation change of 4.5 degrees and 4.3 degrees and a maximal forward shift of 0.33 mm and 0.28 mm was observed for the AT-45 and 1CU, respectively. In vivo, a change in haptic angulation <100 and a maximal forward shift of 0.50 mm was observed for the 1CU. These changes correspond to a theoretical approximate value of 0.50 diopters.

CONCLUSIONS

The in vitro simulation device examined with three-dimensional ultrasound biomicroscopy provided information on the accommodative performance of these potentially accommodative IOL designs. Using three-dimensional ultrasound biomicroscopy, corresponding changes in haptic angulation during pharmacological-induced accommodation were observed.