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Dual optic accommodating lens

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Accommodating IOLs may very well transform the practice of cataract and refractive lens surgery.This is because accommodative IOLs can potentially provide unaided near visual acuity without the optical aberrations and image degradation that may accompany multifocal IOL implantation.

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During accommodative effort, the ring haptics are brought together resulting in a forward axial movement of the optic with a resultant increase in the functional power of the lens.This article will explore the available accommodative technologies under these 3 headings including any limitations concerning lens excursion and accommodative amplitude and examine the potential impact of these IOLs on cataract and refractive surgeons and patients.The Morcher Bio Com Fold Type 43E, Human Optics 1 CU, Lenstec Tetra Flex, and eyeonics crystalens are examples of single-optic IOLs.A recent study using pilocarpine 2% to simulate accommodation and partial coherence interferometry to measure the changes in anterior chamber depth (and, thus, forward movement of the IOL) revealed no more than 0.50 diopters (D) of accommodative amplitude in most cases 2003;9-676).The Morcher Bio Comfold 43E is not approved by the United States Food and Drug Administration (FDA).Single-optic, accommodating IOLs function by changing their position in the capsular bag during accommodative effort with a resulting increase in the effective power but not the inherent power of the lens.

The limitations of these IOLs stem from their inability to move significantly enough to generate large amplitudes of accommodative power that would yield consistently acceptable near visual acuities.

Not only will this enhance cataract surgery results, but it will also enable refractive surgeons to offer their patients a procedure that is unhindered by the restrictions of corneal refractive surgery and presbyopia.

Accommodating lenses can currently be classified into 3 categories: (1) single-optic, (2) dual-optic, (3) and deformable optic IOLs.

The eyeonics crystalens is a 10.5 mm, hinged plate haptic silicone lens with a 4.5 mm optic (Figure 2).

It is the only accommodating IOL that has been approved by the FDA.

The Medennium Smart IOL is a hydrophobic, acrylic IOL that has dimensions (9.5 x 3.5 mm) similar to the natural crystalline lens.