June 2021
Volume 62, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2021
Effect of Preoperative Anterior Chamber Depth and Intraocular Lens Power on Postoperative Pseudophakic Accommodation Following Monofocal Phacoemulsification Cataract Surgery
Author Affiliations & Notes
  • Sophia Joseph
    Indiana University School of Medicine, Indianapolis, Indiana, United States
  • Jennifer Eikenberry
    Indiana University School of Medicine, Indianapolis, Indiana, United States
  • David Keith Wallace
    Indiana University School of Medicine, Indianapolis, Indiana, United States
  • Footnotes
    Commercial Relationships   Sophia Joseph, None; Jennifer Eikenberry, None; David Wallace, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2021, Vol.62, 568. doi:
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      Sophia Joseph, Jennifer Eikenberry, David Keith Wallace; Effect of Preoperative Anterior Chamber Depth and Intraocular Lens Power on Postoperative Pseudophakic Accommodation Following Monofocal Phacoemulsification Cataract Surgery. Invest. Ophthalmol. Vis. Sci. 2021;62(8):568.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Following phacoemulsification cataract surgery with a monofocal intraocular lens, patients generally experience good visual acuity at distance but have varying degrees of accommodative ability. We performed a prospective clinical study to test the hypothesis that preoperative anterior chamber depth (ACD) and/or implanted intraocular lens (IOL) power influence postoperative accommodative ability.

Methods : We enrolled fifteen adult patients (one eye each) who had undergone uncomplicated phacoemulsification cataract surgery more than one month prior by a single surgeon. Eligibility criteria included in-the-bag intraocular lens placement, surgery not requiring mechanical pupil stretching, and postoperative best-corrected distance visual acuity of 20/25 or better. We measured each patient’s near visual acuity with only distance correction in place at 40 centimeters. We then measured amplitude of accommodation by placing a 2.5D lens over the distance correction and asking the patient to read a 20/30 near chart line. The chart was moved forward until blurred and back until clear to establish the near point. This was repeated 10 times and the average near point was used to determine the accommodative amplitude. The preoperative anterior chamber depth as measured by the IOL Master 700 as well as the IOL power implanted was obtained from the patient’s medical record. Multiple linear regression analysis was used to determine if ACD and/or IOL power were associated with pseduophakic patients’ accommodative ability.

Results : Postoperative accommodative ability was associated with larger ACD (p=0.004) but was not associated with IOL power (p = 0.918). For every 1 mm increase in ACD, there was a 2.63 D increase in accommodation.

Conclusions : Larger preoperative ACD predicts better postoperative accommodative ability in our pseudophakic patients. Larger ACD has been shown to correlate with younger age, and it is possible that younger pseudophakic patients retain more accommodation. Additionally, larger ACD has been shown to correlate with larger corneal diameter, and perhaps the larger cornea has more multifocality. These data could potentially be used to inform preoperative decision making when choosing between monofocal and multifocal lenses.

This is a 2021 ARVO Annual Meeting abstract.

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