Objective assessment of accommodation with an accommodative intraocular lens: Development of methodology and case...

To determine the objectively measurable amplitude of accommodation after implantation of an accommodating intraocular lens (IOL).

We used an open field autorefractor based on near infrared retinoscopy (PowerRef3, Plusoptix GmbH, Nuremberg, Germany) to determine the change in refraction, pupil diameter and gaze with decreasing distance of the visual stimulus. We compared the signal curves between a young healthy, a presbyopic and a pseudophakic patient as well as three patients implanted with the accommodative IOL Lumina (AMIPLANT GmbH, Schnaittach, Germany).

The refraction, pupil, and gaze curves exhibit the behavior that are expected from theory. The accommodative IOL shows similar curves as the young phakic person, showing that there is a dynamic change in refraction. This is supported by the three-year follow-up data of a patient providing an uncorrected binocular far VA of 1.0 and near visual acuity of 0.8.

The PowerRef3 is capable of measuring the accommodative amplitude of an accommodative IOL. The Lumina shows a accommodative amplitude of up to 2 D and excellent far and near vision in a patient three years after implantation.