Potentially accommodating intraocular lenses--an in vitro and in vivo study using three-dimensional high-frequency ultrasound.
OBJECTIVE
To investigate the accommodative performance of new intraocular lenses (IOL) using the advantages of three-dimensional ultrasound biomicroscopy.


METHODS
An in vitro simulation device was designed to study IOL performance using an artificial capsular bag and a stretching device. The haptic region of the Akkommodative 1CU (HumanOptics AG) and CrystaLens AT-45 (Eyeonics Inc) was visualized in vitro in three dimensions, using an in-house developed three-dimensional ultrasound biomicroscope. The in vitro results were used to describe the in vivo situation in four patients with accommodative implants.


RESULTS
The haptic position and angulation in consideration of the accommodation state was distinguished and analyzed. In the simulation model, a maximal angulation change of 4.5 degrees and 4.3 degrees and a maximal forward shift of 0.33 mm and 0.28 mm was observed for the AT-45 and 1CU, respectively. In vivo, a change in haptic angulation <100 and a maximal forward shift of 0.50 mm was observed for the 1CU. These changes correspond to a theoretical approximate value of 0.50 diopters.


CONCLUSIONS
The in vitro simulation device examined with three-dimensional ultrasound biomicroscopy provided information on the accommodative performance of these potentially accommodative IOL designs. Using three-dimensional ultrasound biomicroscopy, corresponding changes in haptic angulation during pharmacological-induced accommodation were observed.
Stachs
Oliver
O
Eye Clinic of the University of Rostock, Rostock, Germany. oliver.stachs@med.uni-rostock.de
Schneider
Hanka
H
Stave
Joachim
J
Guthoff
Rudolf
R
D000065:Accommodation, Ocular; D000368:Aged; D000869:Anterior Eye Segment / Q000000981:diagnostic imaging*; D002387:Cataract Extraction; D002924:Ciliary Body / Q000000981:diagnostic imaging* / Q000187:drug effects; D003198:Computer Simulation; D003519:Cyclopentolate / Q000494:pharmacology; D006801:Humans; D021621:Imaging, Three-Dimensional; D007910:Lenses, Intraocular; D008916:Miotics / Q000494:pharmacology; D009184:Mydriatics / Q000494:pharmacology; D010862:Pilocarpine / Q000494:pharmacology; D011474:Prosthesis Design; D014463:Ultrasonography
D008916:Miotics; D009184:Mydriatics; D010862:Pilocarpine; D003519:Cyclopentolate