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Potentially accommodating intraocular lenses--an in vitro and in vivo study using three-dimensional high-frequency
Oliver Stachs1, Hanka Schneider, Joachim Stave
1Eye Clinic of the University of Rostock, Rostock, Germany. oliver.stachs@med.uni-rostock.de
Purpose:
To investigate the accommodative performance of new intraocular lenses (IOL) using the advantages of three-dimensional ultrasound biomicroscopy.
Methods:
An in vitro simulation device was designed to study IOL performance using an artificial capsular bag and a stretching device. The haptic region of the Akkommodative 1CU (HumanOptics AG) and CrystaLens AT-45 (Eyeonics Inc) was visualized in vitro in three dimensions, using an in-house developed three-dimensional ultrasound biomicroscope. The in vitro results were used to describe the in vivo situation in four patients with accommodative implants.
Results:
The haptic position and angulation in consideration of the accommodation state was distinguished and analyzed. In the simulation model, a maximal angulation change of 4.5 degrees and 4.3 degrees and a maximal forward shift of 0.33 mm and 0.28 mm was observed for the AT-45 and 1CU, respectively. In vivo, a change in haptic angulation <100 and a maximal forward shift of 0.50 mm was observed for the 1CU. These changes correspond to a theoretical approximate value of 0.50 diopters.
Conclusions:
The in vitro simulation device examined with three-dimensional ultrasound biomicroscopy provided information on the accommodative performance of these potentially accommodative IOL designs. Using three-dimensional ultrasound biomicroscopy, corresponding changes in haptic angulation during pharmacological-induced accommodation were observed.
