Feasibility and development of a high-power real accommodating intraocular lens

Area of Science:

• Ophthalmology
• Biomedical Engineering
• Materials Science

Background:

• Cataract surgery often requires intraocular lenses (IOLs) that lack accommodative function, limiting patients' near vision.
• Restoring the eye's natural ability to focus (accommodation) is a key goal in IOL development.
• Current IOLs typically offer fixed focal points, necessitating reading glasses for near tasks.

Purpose of the Study:

• To engineer an accommodating intraocular lens (IOL) capable of dynamic power adjustment.
• To achieve a minimum of 8.0 diopters (D) of accommodative amplitude through ciliary body action.
• To utilize a flexible material manipulated between a rigid plate and a capsular diaphragm.

Main Methods:

• A laboratory lens model was used to test the feasibility of the accommodating IOL concept.
• An implantable measuring device simulated IOL action and was tested in monkey eyes.
• Ultrasound biomicroscopy (UBM) documented dynamic changes in lens curvature in response to pharmacologically induced ciliary muscle states (spasm and relaxation).

Main Results:

• The laboratory model demonstrated a potential accommodation exceeding 50.0 D.
• UBM imaging revealed significant changes in lens curvature, translating to a calculated accommodative range of 9.0 to 53.0 D.
• The prototype accommodating IOL implanted in monkey eyes showed active power changes exceeding 40.0 D.

Conclusions:

• Flexible materials can be effectively manipulated within an ocular implant system.
• The developed IOL concept, utilizing flexible material between specific ocular structures, successfully generated substantial accommodative amplitude in vivo.
• This approach holds promise for creating IOLs that restore functional accommodation in pseudophakic eyes.