2020–2021 BCSC Basic and Clinical Science Course™
3 Clinical Optics
Chapter 6: Intraocular Lenses
Multifocal Intraocular Lenses
Accommodating Intraocular Lenses
These lenses are essentially monofocal IOLs designed to allow some degree of improved near vision. Usually, such designs involve linking accommodative effort to an anterior movement of the IOL, thereby increasing its effective power in the eye. This mechanism may be more effective with higher-power IOLs because their effective powers are more sensitive to small changes in position than are those of lower-power IOLs. The United States Food and Drug Administration (FDA) has approved one design that has shown some degree of accommodation, and other designs are awaiting FDA approval. However, currently, there is no clinical evidence that “accommodating” IOLs change axial position in the eye during near-vision tasks.
Cumming JS, Colvard DM, Dell SJ, et al. Clinical evaluation of the Crystalens AT-45 accommodating intraocular lens: results of the U.S. Food and Drug Administration clinical trial. J Cataract Refract Surg. 2006;32(5):812–825.
Dhital A, Spalton DJ, Gala KB. Comparison of near vision, intraocular lens movement, and depth of focus with accommodating and monofocal intraocular lenses. J Cataract Refract Surg. 2013;39(12):1872–1878.
Findl O, Kiss B, Petternel V, et al. Intraocular lens movement caused by ciliary muscle contraction. J Cataract Refract Surg. 2003;29(4):669–676.
Kohl JC, Werner L, Ford JR, et al. Long-term uveal and capsular biocompatibility of a new accommodating intraocular lens. J Cataract Refract Surg. 2014;40(12):2113–2119.
Langenbucher A, Huber S, Nguyen NX, Seitz B, Gusek-Schneider GC, Küchle M. Measurement of accommodation after implantation of an accommodating posterior chamber intraocular lens. J Cataract Refract Surg. 2003;29(4):677–685.
Matthews MW, Eggleston HC, Hilmas GE. Development of a repeatedly adjustable intraocular lens. J Cataract Refract Surg. 2003;29(11):2204–2210.
Matthews MW, Eggleston HC, Pekarek SD, Hilmas GE. Magnetically adjustable intraocular lens. J Cataract Refract Surg. 2003;29(11):2211–2216.
Excerpted from BCSC 2020-2021 series : Section 3 - Clinical Optics. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.