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Marcus Mittag, Ria Beck, Oliver Stachs, Rudolf Guthoff; Evaluation Of The Accommodative Performance Of The Crystalens HD500. Invest. Ophthalmol. Vis. Sci. 2011;52(14):851.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the ability to accommodate and visual outcomes in patients after cataract surgery using the accommodating IOL Crystalens HD 500.
Three patients, aged 65-74 years, underwent cataract surgery followed by implantation of the Crystalens HD 500 in both eyes and were followed up for 6 months. Exclusion criteria were any eye pathologies and corneal astigmatism over 0.75 dpt. Uncorrected (UDVA) and corrected (CDVA) distance visual acuity and distance corrected intermediate (DCIVA / 80 cm) and near (DCNVA / 40cm) visual acuity were measured using ETDRS and Jaeger charts. Anterior chamber depth (ACD) was obtained using partial coherence interferometry (PCI) with an optical stimulus, objective accommodation was determined with wavefront aberrometry and subjective accommodation using defocus curves. These were performed at photopic (30 cd/m2) and mesopic (3 cd/m2) conditions. Pupil diameters were extracted from the aberrometry data.
DCNVA was in mean 0.317+/- 0.07 logMAR under photopic and 0.549 +/- 0.14 logMAR under mesopic conditions 6 months post-op. Spherical equivalent of all eyes was in mean -0.56 dpt. +/- 0.39 dpt. Mean change of ACD focusing a -3 dpt. target was 11.67 +/- 8.78 µm. No reproducible changes in higher and lower order aberrations were observed in the aberrometry. The mean change of pupil diameter focusing a 40 cm target was -0.145 +/-0.229 mm under photopic and 0.716 +/-0.223 mm under mesopic conditions. The subjective accommodative range was 1.58 +/- 0.37 dpt under photopic and 1.25 +/- 0.27 dpt under mesopic conditions.
No objective accommodative action of the IOL, neither a forward shift nor an "arching" or similar change of the IOL configuration, was observed. The DCNVA decreased with an increase of the pupil diameter under mesopic conditions. All patients had minimal astigmatism at least in one eye. Pseudoaccommodative effects, i.e. pinhole effect combined with minimal astigmatism and slight myopia could explain the subjective accommodative range.
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