[Long-term experience of a pseudo-accommodative lens]

The aim of this study was to investigate the clinical long-term outcome of the 1CU posterior chamber IOL. Objective accommodative dynamics as well as measured data were assessed subjectively three months and 72 months after implantation.

Retrospectively, 26 eyes after uneventful cataract surgery with 1CU IOL implantation were included. In 26 eyes (group I), the change of the anterior IOL reflex without and under stimulation with pilocarpine 1 %, and cyclopentolate (pseudophakic-accommodation), and maximum obfuscation under best corrected visual acuity (BCVA) settings (pseudo-accommodation) were examined. In 20 eyes (group II) the influence of the laser capsulotomy on the pseudophakic-accommodation was evaluated.

Eyes, stimulated by pilocarpine 1 %, have an anterior (-) shift of the IOL reflex of -0.59 +/- 0.28 mm (pseudophakic-accommodation) after 3 months and -0.49 +/- 0.27 mm after 50.8 months (p < 0.001). The mean obfuscation under BCVA level (pseudo-accommodation) was 1.5 diopters (D). Laser capsulotomy was performed after 21 +/- 15 months in the mean. A change of the anterior reflex of the IOL of -0.5 +/- 0.3 mm before and after Nd:YAG laser treatment did not show any statistical significance.

Under application of pilocarpine 1 % and cyclopentolate a small movement of the 1CU-IOL was examined. The amount of the anterior/posterior shift of the IOL reflex was stable over the follow-up period but is not sufficient to provide full presbyopic correction.