Refractive Lens Surgery

Chapter 11 Presbyopia – Cataract Surgery 107
Table 11.2. Findings in 30 eyes of 30 patients at different time points following implantation of the 1CU accommodative
posterior chamber intraocular lens. Indicated are mean, standard deviation, median and range
Three months Six months Twelve months
Spherical equivalent –0.28±0.54 –0.29±0.52 –0.21±0.54
of distance refraction (D) –0.25, –1.38 to +0.75 –0.25, –1.38 to +0.5 –0.25, –1.13 to +0.5
Accommodative range 1.93±0.47 1.85±0.62 2.02±0.38
determined by near point (D) 2.0, 1.0–2.78 1.85, 0.5–2.7 2.0, 1.32–2.56
Anterior chamber depth (mm) 4.40±0.44 4.35±0.50 4.25±0.53
4.47, 3.30–5.21 4.45, 3.30–5.23 4.30, 3.28–4.97
Near visual acuity with best 0.41±0.15 0.37±0.12 0.39±0.11
distance correction (Birkhäuser 0.4, 0.2–0.7 0.3, 0.2–0.6 0.4, 0.3–0.6
reading charts in 35 cm)
and corresponding Jaeger values
(J3, J10–J1) (J7, J10–J1) (J3, J7–J1)
Fig. 11.5. Box plots showing accommodative
range (D) determined by near point at different
time points after implantation of the new accommodative
1CU posterior chamber intraocular lens
in 15 patients. The boxes include 50% of measured
values (between the 25th and 75th percentiles) and
show the position of the median (horizontal line).
The error bars indicate 1.5 times the interquartile
distance from the upper and lower box edges
Our results indicate that for up to 12
months, the 1CU PCIOL shows no tendency
of myopization, anterior movement of the
lens optic or loss of distance-corrected near
visual acuity. One possible explanation for
these encouraging observations may be that
we observed very little fibrosis of the capsular
bag or the anterior and posterior lens capsule.
This may be a result of the design of the
1CU PCIOL and the fact that we carefully
performed a well-centered round capsulorrhexis
of 5 mm with the remaining anterior
lens capsule circumferentially covering the
rim of the PCIOL optic. Furthermore, we
carefully observed inclusion and exclusion
criteria that excluded eyes with potential
zonular weakness and tendencies to develop
increased fibrosis of the lens capsule, i.e.
traumatic changes, pseudoexfoliation, and
proliferative diabetic retinopathy.
Based on our findings, we conclude that it
is unlikely that problems such as anterior
vaulting, anterior movement or dislocation of
the 1CU PCIOL will occur after more than 12
months. Nevertheless, we believe that further
studies with longer follow-up and a randomized,
masked, multicenter design are needed
to analyze further the 1CU PCIOL with
regard to long-term biocompatibility and
accommodative properties.