Drug-induced intraocular lens movement and near visual acuity after AcrySof intraocular lens implantation.
OBJECTIVE
To evaluate the factors influencing AcrySof intraocular lens (IOL) (Alcon Laboratories) movement and near visual acuity after cyclopentolate 1% and pilocarpine 2%.


METHODS
Department of Ophthalmology, University of Ankara, Ankara, Turkey.


METHODS
Thirty eyes of 22 patients with AcrySof IOL implantation were included in this prospective study. Near visual acuity (Jaeger) at 35 cm through best distance correction without an add and pupil diameter were measured and correlated with anterior chamber depth (ACD) measured with ultrasound biomicroscopy (UBM) after application of cyclopentolate 1% and pilocarpine 2%, respectively. The magnitude of the change in the ACD was correlated with the accommodation amplitude, patient age, time interval between surgery and imaging, preoperative axial length, capsulorhexis diameter, ACD during cycloplegia, IOL diameter, and presence of posterior capsule opacification (PCO).


RESULTS
Near visual acuity significantly decreased after application of cyclopentolate 1% and increased after application of pilocarpine 2% (P < .001) in all eyes. The IOL moved anteriorly in 8 (26%) eyes and posteriorly in 22 (74%) eyes after pilocarpine 2%. There was no correlation between the ACD and near visual acuity under cyclopentolate 1% (r = 0.06, P > .05) or pilocarpine 2% (r = 0.04, P > .05). There was a moderate correlation between the anterior IOL movement and accommodation amplitude (P < .05, r = 0.42). There was no correlation between the magnitude of the IOL movement and patient age, time interval between surgery and imaging, the preoperative axial length, capsulorhexis diameter, ACD during cycloplegia, IOL diameter, and the presence of PCO (P > .05).


CONCLUSIONS
There was better near visual acuity in all eyes with the AcrySof MAIOL, although most IOLs move slightly backward after of pilocarpine 2%. This points out pseudoaccommodation rather than pseudophakic accommodation. Ultrasound biomicroscopy is useful in determining the ACD and the relation between the IOL and the surrounding tissues after cataract surgery.
Muftuoglu
Orkun
O
Ankara University School of Medicine, Department of Ophthalmology, Ankara, Turkey. orkunm@yahoo.com
Hosal
Banu Melek
BM
Karel
Fatih
F
Zilelioglu
Guler
G
D000065:Accommodation, Ocular / Q000187:drug effects*; D000180:Acrylic Resins; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000867:Anterior Chamber / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D019923:Capsulorhexis; D002924:Ciliary Body / Q000187:drug effects; D003519:Cyclopentolate / Q000008:administration & dosage; D005260:Female; D005548:Foreign-Body Migration / Q000209:etiology*; D006801:Humans; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular; D008297:Male; D008875:Middle Aged; D008916:Miotics / Q000008:administration & dosage*; D009184:Mydriatics / Q000008:administration & dosage*; D018918:Phacoemulsification; D010862:Pilocarpine / Q000008:administration & dosage; D014463:Ultrasonography; D014792:Visual Acuity / Q000187:drug effects*
D000180:Acrylic Resins; D008916:Miotics; D009184:Mydriatics; D010862:Pilocarpine; D003519:Cyclopentolate