UBM Changes during Accommodation in Eyes Implanted with Crystalens AT 45 and 1CU IOL. A Pilot Study

Abstract

Abstract: : Purpose: (a) To measure accomodation in pseudophakic eyes implanted with 1CU and AT45 "accomodative" IOL and (b) to explore, in the same eyes, changes in the anterior segment anatomy by UBM imaging Methods: Study design: prospective case series, 1 month follow up. Population: 17 patients (24 eyes), scheduled for cataract surgery (clear cornea phacoemulsification in local anaesthesia, two surgeons, GM and SAG) , agreed to participate in the study. In 14 eyes (10 patients) an AT45 IOL was implanted. 10 eyes (7 patients) were scheduled for a 1CU IOL. Age : 45-65 years. Pre-operative best corrected visual acuity: 20/63 – 20/32. Study procedures: (a) accomodation was measured by adding a negative sphere to the far-distance correction until 4/5 letters of the smallest detectable line were properly identified. (b) anterior chamber depth (i.e. the distance between the posterior endothelium and the anterior optic of the IOL ) and the amplitude of the scleral-ciliary process angle were measured by UBM in an accomodation-solicited condition and in a relaxation state. The measurements were made on the individual UBM images by two "masked" independent observers (RT and PM Results: No surgery-related complications were observed. Post-operative uncorrected far distance visual acuity ranged between 20/25 and 20/16. The 1-month data on accomodation, and on the decrease of (a) the AC depth and (b) the sclero-ciliary angle, upon solicited accomodation, are summarized in the table: Conclusions: Both IOL(s) led to a detectable accomodation. During accomodation, a decrease in anterior chamber depth and an anterior rotation of the ciliary body were observed.  

Keywords: accommodation • cataract • visual acuity