Refractive Lens Surgery

10
The Eyeonics Crystalens
Steven J. Dell
CORE MESSAGES
2 Early observations with standard plate-haptic intraocular lenses
suggested that an accommodating lens could be designed to take
advantage of the hydraulic gradient present between the anterior
and posterior chambers during ciliary muscle contraction. These
observations led to the development of the Eyeonics Crystalens.
2 The Eyeonics Crystalens is a modified plate-haptic silicone accommodating
intraocular lens designed to flex anteriorly in response
to ciliary muscle contraction. As vitreous pressure increases in
response to action of the ciliary muscle, the Crystalens moves anteriorly.
2 Crystalens FDA clinical trial results demonstrate that near vision
through the distance correction is significantly improved over that
typically achieved with traditional intraocular lenses. Dysphotopsia
has been rare despite the relatively small 4.5-mm optic,and contrast
sensitivity results have been comparable to standard intraocular
lenses.
2 Patient satisfaction with the Crystalens has been very good, with a
high percentage of patients achieving spectacle independence for
distance, intermediate and near tasks. The accommodative effect
persists after YAG capsulotomy, and it has been sustained throughout
the duration of clinical experience with the lens.
2 Precision biometry and a watertight wound closure are essential to
achieve good clinical results with the Crystalens. Corneal astigmatism
should be addressed at the time of surgery, typically with limbal
relaxing incisions. Cycloplegia is essential in the early postoperative
period to ensure correct positioning of the lens.