Purpose
Document with UBM study the anatomical and accommodative intraocular changes that occur with pharmacological accommodative stimulus using 2% pilocarpine in eyes with accommodative IOLs implantation.
Methods
METHODS patients undergoing cataract surgery with intraocular accommodative lens placement during 2012. Measurements in millimeters of the lens-corneal endothelium distance (LCED) , irido-corneal angle (ICA) and trabecular ciliary body distance (TCBD) were taken using UBM study, all of them with superior and nasal orientation. Then we apply one drop of pilocarpine 2% every 15 minutes and measure the same variables.
Results
patients undergoing cataract surgery with accommodative lens placement from January to September 2012. Three patients attended the study, all with placement of accommodative IOLs in both eyes, six eyes were analyzed. The average age was 60 years, the average IOLs power was 22.9 diopters. To analyze the data we search a significant difference between the measurements obtained at baseline and after application of pilocarpine. We calculate the mean, median and standard deviation. Finally data was analyzed using F Fisher statistic method with 5 degrees of freedom and 95% interval confidence looking for a P value less than 0.05.
Conclusions
Pilocarpine induced no significant changes in the anterior displacement of the IOLs. Assuming the anterior displacement of the IOLs provides accommodative capacity, endothelium lens distance should decrease, however, in this study we found no correlation between them. Also found no significant difference between the distance trabecular ciliary body and iridocorneal angle. We conclude that pilocarpine does not induce any change in position of the lens in spite of several studies that reported a change in lens position using this method, the present study found no significant difference in the measurement of anterior chamber depth, iridocorneal angle and trabecular ciliary body distance. More studies with a larger number of patients and long-term follow-up is needed to document the loss of motility of the lens over time, whereas capsular fibrosis is an expected consequence of cataract surgery, we assume that the accommodative IOLs analyzed in this study have already presented some type of capsular fibrosis impeding the proper functioning of the accommodative IOLs.
Keywords: 404 accommodation •
567 intraocular lens •
653 presbyopia