2020–2021 BCSC Basic and Clinical Science Course™
13 Refractive Surgery
Chapter 8: Intraocular Refractive Surgery
Accommodating Intraocular Lenses
Accommodating lenses are another alternative for implantation during refractive lens exchange. Currently, only 1 accommodating IOL and a similar accommodating toric IOL are FDA approved, although others are being investigated. Development is also currently under way for dual-optic IOLs and deformable IOLs. Additional investigational IOLs are discussed in Chapter 9.
Although the accommodating lens was designed to improve distance, intermediate, and near acuity through movement of its hinged haptics during the accommodative process, studies have found limited IOL movement and limited improvement in near acuity for most patients targeted for best distance acuity. Thus, many surgeons are utilizing a “mini-monovision” strategy when implanting the accommodating IOL, leaving the nondominant eye targeted for slight myopia (–0.50 to –0.75 D).
Gooi P, Ahmed IK. Review of presbyopic IOLs: multifocal and accommodating IOLs. Int Ophthalmol Clin. 2012;52(2):41–50.
Hoffman RS, Fine IH, Packer M. Accommodating IOLs: current technology, limitations, and future designs. Current Insight. San Francisco: American Academy of Ophthalmology. Available at www.aao.org/current-insight/accommodating-iols-current-technology-limitations-. Accessed November 6, 2016.
Excerpted from BCSC 2020-2021 series: Section 13 - Refractive Surgery. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.