Pilocarpine-induced shift of an accommodating intraocular lens: AT-45 Crystalens.
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.
Koeppl
Christina
C
Department of Ophthalmology, Medical University of Vienna, Viena, Austria.
Findl
Oliver
O
Menapace
Rupert
R
Kriechbaum
Katharina
K
Wirtitsch
Matthias
M
Buehl
Wolf
W
Sacu
Stefan
S
Drexler
Wolfgang
W
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
D008916:Miotics; D010862:Pilocarpine