Pseudophakic accommodation and pseudoaccommodation under physiological conditions measured with partial coherence interferometry.
OBJECTIVE
To distinguish pseudophakic accommodation from pseudoaccommodation by measuring the physiologically and pharmacologically induced anterior chamber depth (ACD) shifts.


METHODS
Department of Ophthalmology, University of Debrecen, Debrecen, Hungary.


METHODS
This study comprised 100 pseudophakic eyes of 79 patients. Forty patients (Group 1) received the AcrySof MA60AC intraocular lens (IOL) (Alcon Laboratories), 50 patients (Group 2) received the SA60AT IOL (Alcon Laboratories), and 10 patients (Group 3) received the apodized diffractive SA60D3 ReSTOR IOL. Visual function was evaluated a mean of 10.2 months +/- 9.2 (SD) postoperatively, and the total pseudoaccommodative amplitude was determined with a defocusing technique. To distinguish pseudophakic accommodation from pseudoaccommodation, ACD measurements were performed using partial coherence interferometry during distance fixation and physiologic accommodation after pharmacologic relaxation of the ciliary muscle.


RESULTS
Best corrected distance and near visual acuities were similar in the 3 groups (P = .75 and P = .08, respectively). Distance corrected near visual acuity was significantly better in Group 3 (P < .001), with all eyes achieving J1 or better. Three percent in Group 1 and 8% in Group 2 achieved J1 or better. Subjective accommodation was similar in Groups 1 and 2 (-0.82 +/- 0.18 diopter [D] and -1.00 +/- 0.35 D, respectively; P = .3). Group 3 had an accommodation curve with 2 peaks. Intraocular lens movement differences between the groups were not significant (physiologic stimulus: P = .07; cyclopentolate: P = .46), and significant ACD shifts from baseline were not detected (physiologic stimulus: P = .14; cyclopentolate: P = .10).


CONCLUSIONS
Pseudoaccommodative amplitude of the investigated monofocal IOLs was independent of IOL movement. Anterior shift did not affect good near visual acuity with the AcrySof ReSTOR IOL.
Tsorbatzoglou
Alexis
A
Department of Ophthalmology, Medical and Health Science Center, University of Debrecen, Debrecen, Hungary. alex@jaguar.unideb.hu
Németh
Gábor
G
Máth
János
J
Berta
András
A
D000065:Accommodation, Ocular / Q000502:physiology*; D000368:Aged; D000369:Aged, 80 and over; D000867:Anterior Chamber / Q000033:anatomy & histology; D001699:Biometry; D002924:Ciliary Body / Q000187:drug effects; D003519:Cyclopentolate / Q000008:administration & dosage; D006801:Humans; D007368:Interferometry / Q000379:methods; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular; D008027:Light; D008875:Middle Aged; D009184:Mydriatics / Q000008:administration & dosage; D018918:Phacoemulsification; D011446:Prospective Studies; D019591:Pseudophakia / Q000503:physiopathology*; D014792:Visual Acuity
D009184:Mydriatics; D003519:Cyclopentolate