title: Objective accommodative amplitude and dynamics with the 1CU accommodative intraocular lens.
abstract: OBJECTIVE
  To compare the objective accommodative amplitude and dynamics of eyes implanted with the one-compartment-unit (1CU; HumanOptics AG, Erlangen, Germany) accommodative intraocular lenses (IOLs) with that measured subjectively.
  
  
  METHODS
  Twenty eyes with a 1CU accommodative IOL implanted were refracted and distance and near acuity measured with a logMAR (logarithm of the minimum angle of resolution) chart. The objective accommodative stimulus-response curve for static targets between 0.17 and 4.00 D accommodative demand was measured with the SRW-5000 (Shin-Nippon Commerce Inc., Tokyo, Japan) and PowerRefractor (PlusOptiX, Nürnberg, Germany) autorefractors. Continuous objective recording of dynamic accommodation was measured with the SRW-5000, with the subject viewing a target moving from 0 to 2.50 D at 0.3 Hz through a Badal lens system. Wavefront aberrometry measures (Zywave; Bausch & Lomb, Rochester, NY) were made through undilated pupils. Subjective amplitude of accommodation was measured with the RAF (Royal Air Force accommodation and vergence measurement) rule.
  
  
  RESULTS
  Four months after implantation best-corrected acuity was -0.01 +/- 0.16 logMAR at distance and 0.60 +/- 0.09 logMAR at near. Objectively, the static amplitude of accommodation was 0.72 +/- 0.38 D. The average dynamic amplitude of accommodation was 0.71 +/- 0.47 D, with a lag behind the target of 0.50 +/- 0.48 seconds. Aberrometry showed a decrease in power of the lens-eye combination from the center to the periphery in all subjects (on average, -0.38 +/- 0.28 D/mm). Subjective amplitude of accommodation was 2.24 +/- 0.42 D. Two years after 1CU implantation, refractive error and distance visual acuity remained relatively stable, but near visual acuity, and the subjective and objective amplitudes of accommodation decreased.
  
  
  CONCLUSIONS
  The objective accommodating effects of the 1CU lens appear to be limited, although patients are able to track a moving target. Subjective and objective accommodation was reduced at the 2-year follow-up. The greater subjective amplitude of accommodation is likely to result from the eye's depth of focus of and the aspheric nature of the IOL.
authors.affiliation: School of Life and Health Sciences, Aston University, Birmingham, United Kingdom. j.s.w.wolffsohn@aston.ac.uk
authors.forename: James Stuart
authors.initials: JS
authors.lastname: Wolffsohn
authors.forename: Olivia Anne
authors.initials: OA
authors.lastname: Hunt
authors.forename: Shehzad
authors.initials: S
authors.lastname: Naroo
authors.forename: Bernard
authors.initials: B
authors.lastname: Gilmartin
authors.forename: Sunil
authors.initials: S
authors.lastname: Shah
authors.forename: Ian Andrew
authors.initials: IA
authors.lastname: Cunliffe
authors.forename: Mark Timothy
authors.initials: MT
authors.lastname: Benson
authors.forename: Sanjay
authors.initials: S
authors.lastname: Mantry
mesh_terms: D000065:Accommodation, Ocular / Q000502:physiology*; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification; D012029:Refraction, Ocular / Q000502:physiology; D014792:Visual Acuity / Q000502:physiology*