title: Pilocarpine-induced shift of an accommodating intraocular lens: AT-45 Crystalens.
abstract: OBJECTIVE
  To measure the shift of an accommodating plate-haptic intraocular lens (IOL) along the visual axis induced by ciliary muscle contraction after application of pilocarpine.
  
  
  METHODS
  Department of Ophthalmology, Medical University of Vienna, Vienna, Austria.
  
  
  METHODS
  Fifty-four eyes of 28 patients with age-related cataract comprised this prospective study. Each patient received an AT-45 silicone accommodating IOL (Crystalens, Eyeonics Corp.) after standardized cataract surgery. In a subgroup of 24 eyes, capsular bag fibrosis was reduced by extensive polishing of the anterior capsule with a slit cannula. Assessment included measurements of anterior chamber depth, assessed with partial coherence interferometry, before and after application of pilocarpine 2% and evaluation of near visual acuity 1 month and 3 months postoperatively.
  
  
  RESULTS
  A slight backward shift of the IOL of 151 mum in the nonpolished group (P < .001) and 122 mum in the polished group (P < .005) could be detected after application of pilocarpine. Polishing the capsule did not influence IOL shift. The median near visual acuity with distance correction 1 month and 3 months postoperatively was J5 and J4, respectively, in the nonpolished group and J6 at both times in the polished group.
  
  
  CONCLUSIONS
  Pilocarpine induced a counterproductive active backward shift of the AT-45 IOL. Polishing of the capsular bag had no impact on accommodative ability. The reading performance of patients with the AT-45 IOL patients at 1 and 3 months was not significantly different from that of with a standard IOL under similar testing methods.
authors.affiliation: Department of Ophthalmology, Medical University of Vienna, Viena, Austria.
authors.forename: Christina
authors.initials: C
authors.lastname: Koeppl
authors.forename: Oliver
authors.initials: O
authors.lastname: Findl
authors.forename: Rupert
authors.initials: R
authors.lastname: Menapace
authors.forename: Katharina
authors.initials: K
authors.lastname: Kriechbaum
authors.forename: Matthias
authors.initials: M
authors.lastname: Wirtitsch
authors.forename: Wolf
authors.initials: W
authors.lastname: Buehl
authors.forename: Stefan
authors.initials: S
authors.lastname: Sacu
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Drexler
mesh_terms: D000065:Accommodation, Ocular / Q000187:drug effects; D000368:Aged; D000369:Aged, 80 and over; D002924:Ciliary Body / Q000187:drug effects*; D005548:Foreign-Body Migration / Q000209:etiology*; D006801:Humans; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular; D008875:Middle Aged; D008916:Miotics / Q000009:adverse effects*; D009119:Muscle Contraction / Q000187:drug effects*; D009130:Muscle, Smooth / Q000187:drug effects; D018918:Phacoemulsification; D010862:Pilocarpine / Q000009:adverse effects*; D011446:Prospective Studies; D011474:Prosthesis Design
chemical_list: D008916:Miotics; D010862:Pilocarpine