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Vol 3, No 2 (2018)
ORIGINAL PAPERS
Published online: 2018-11-29
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Subjective and objective accommodation of the Crystalens Advanced Optics (AO) in patients 6 months after bilateral implantation

Marcus Walckling, Ria Beck, Oliver Stachs, Rudolf F. Guthoff
DOI: 10.5603/OJ.2018.0034
·
Ophthalmol J 2018;3(2):29-36.

open access

Vol 3, No 2 (2018)
ORIGINAL PAPERS
Published online: 2018-11-29

Abstract

Background: The aim of this study was to analyze and compare objective and subjective accommodation in patients after bilateral implantation of the FDA-approved accommodating Crystalens Advanced Optics (AO). Material and methods: This study was performed on 8 eyes of 4 patients. The subjective accommodation was measured by monocular and binocular defocus curves under photopic and mesopic conditions. The objective accommodation was analyzed using partial coherence interferometry (PCI) and wavefront aberration. Pupil diameter at different set-ups and refraction were derived from wavefront data. Results: Uncorrected and corrected distance and uncorrected near visual acuity improved significantly following implantation of the Crystalens AO in all eyes. Only one patient needed spectacles to correct distance visual acuity. Mean distance uncorrected visual acuity was 0.05 ± 0.06 logMAR. All patients were able to read newspapers without spectacles. Mean near uncorrected visual acuity was 0.17 ± 0.12 logMAR. Subjective accommodative amplitude under photopic conditions was significantly better binocularly than monocularly (p = 0.03) and was significant worse monocularly under mesopic conditions than photopic conditions (p = 0.016). No significant changes in anterior chamber depth were observed by PCI, with a fixation on optical stimuli at different distances. There were also no significant changes in the wavefront aberrations between the different set-ups. Pupil diameter increased significantly in the near set-up under mesopic conditions. Conclusions: No objective change in lens configuration was observed under different set-ups. Due to a variety of factors involved in pseudoaccommodation (e.g. pupil diameter, astigmatism, and multifocality), the subjective accommodative amplitude tends to be overestimated relative to objective measurements. No real accommodative action was observed.

Abstract

Background: The aim of this study was to analyze and compare objective and subjective accommodation in patients after bilateral implantation of the FDA-approved accommodating Crystalens Advanced Optics (AO). Material and methods: This study was performed on 8 eyes of 4 patients. The subjective accommodation was measured by monocular and binocular defocus curves under photopic and mesopic conditions. The objective accommodation was analyzed using partial coherence interferometry (PCI) and wavefront aberration. Pupil diameter at different set-ups and refraction were derived from wavefront data. Results: Uncorrected and corrected distance and uncorrected near visual acuity improved significantly following implantation of the Crystalens AO in all eyes. Only one patient needed spectacles to correct distance visual acuity. Mean distance uncorrected visual acuity was 0.05 ± 0.06 logMAR. All patients were able to read newspapers without spectacles. Mean near uncorrected visual acuity was 0.17 ± 0.12 logMAR. Subjective accommodative amplitude under photopic conditions was significantly better binocularly than monocularly (p = 0.03) and was significant worse monocularly under mesopic conditions than photopic conditions (p = 0.016). No significant changes in anterior chamber depth were observed by PCI, with a fixation on optical stimuli at different distances. There were also no significant changes in the wavefront aberrations between the different set-ups. Pupil diameter increased significantly in the near set-up under mesopic conditions. Conclusions: No objective change in lens configuration was observed under different set-ups. Due to a variety of factors involved in pseudoaccommodation (e.g. pupil diameter, astigmatism, and multifocality), the subjective accommodative amplitude tends to be overestimated relative to objective measurements. No real accommodative action was observed.

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Keywords

accommodation; Crystalens; presbyopia correction

About this article
Title

Subjective and objective accommodation of the Crystalens Advanced Optics (AO) in patients 6 months after bilateral implantation

Journal

Ophthalmology Journal

Issue

Vol 3, No 2 (2018)

Pages

29-36

Published online

2018-11-29

DOI

10.5603/OJ.2018.0034

Bibliographic record

Ophthalmol J 2018;3(2):29-36.

Keywords

accommodation
Crystalens
presbyopia correction

Authors

Marcus Walckling
Ria Beck
Oliver Stachs
Rudolf F. Guthoff

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