Pilot study of new focus-shift accommodating intraocular lens.

PURPOSE

To determine the visual and accommodative performance of the OPAL-A focus-shift accommodating intraocular lens (IOL).

SETTING

Department of Ophthalmology, St. Thomas' Hospital, London, United Kingdom.

METHODS

In this study comprising unilateral phacoemulsification and accommodating IOL implantation, patients were followed for 6 months. Corrected distance (CDVA) and distance-corrected near (DCNVA) visual acuities were measured. Objective amplitude of accommodation was measured with an autorefractor and subjective amplitude of accommodation, using push-up tests and defocus curves. Physiological and pilocarpine-stimulated IOL movement was measured by anterior segment optical coherence tomography.

RESULTS

The mean values at 1 month, 3 months, and 6 months, respectively, were as follows: CDVA, -0.06 +/- 0.08 (SD), -0.08 +/- 0.09, and -0.05 +/- 0.09; DCNVA, 0.31 +/- 0.15, 0.31 +/- 0.15, and 0.34 +/- 0.16; objective amplitude of accommodation, 0.36 +/- 0.38 diopters (D), 0.12 +/- 0.34 D, and 0.10 +/- 0.34 D; subjective amplitude of accommodation, 2.79 +/- 0.86 D, 2.55 +/- 0.85 D, and 2.50 +/- 0.62 D with push-up test and 0.90 +/- 0.40 D, 0.78 +/- 0.23 D, and 0.93 +/- 0.35 D with defocus curves. The maximum physiologic IOL shift at 1 month (mean 45.2 +/- 63.4 microm) occurred with a 3.0 D accommodative stimulus. At 6 months, the mean pilocarpine-stimulated forward IOL shift was 306 +/- 161 microm.

CONCLUSIONS

Objective accommodation and forward axial shift were clinically insignificant with the accommodating IOL. The near visual performance was attributed to depth of focus rather than to true pseudophakic accommodation.