Evaluation of Verisyse and Artiflex phakic intraocular lenses during accommodation using Visante optical coherence tomography.
OBJECTIVE
To perform a dynamic study of the relationship between Verisyse (AMO) and Artiflex (Ophtec B.V.) phakic intraocular lenses (pIOLs) and anterior chamber structures during accommodation using optical coherence tomography (OCT) (Visante, Carl Zeiss Meditec, Inc.)


METHODS
Institutional practice.


METHODS
Eleven myopic patients were randomly selected to have implantation of a Verisyse pIOL in 1 eye and an Artiflex pIOL in the other. Using a 2-dimensional image, dynamic measurements of the relationship between the anterior surface of the pIOL and the corneal endothelium, the posterior surface of the pIOL and the anterior surface of the crystalline lens, and the pupil diameter were performed using Visante OCT. Physiological accommodation was stimulated by adding lenses in 1.00 diopter (D) steps from +1.00 to -7.00 D.


RESULTS
Both groups had a significant decrease in pupil diameter (P<.0001, generalized linear model [GLM]) and in the distance between the anterior surface of the pIOL and the corneal endothelium (P<.0001, GLM) with accommodation. There were no statistically significant changes in the distance between the posterior surface of either pIOL and the anterior surface of the crystalline lens (P = .2845, GLM). There were no statistically significant differences between the 2 pIOLs in any measurement (P>.05, GLM).


CONCLUSIONS
The results fit with Helmholtz' theory of accommodation as forward movement of the diaphragm iris-crystalline lens was seen. There was a decrease in the distance between the pIOL and corneal endothelium and in the pupil diameter, whereas the distance between both pIOLs and the crystalline lens remained constant throughout the accommodation examination. This suggests that the risk for cataract from intermittent contact between the crystalline lens and IOL from accommodative effort is unlikely.
Instituto de Microcirugia Ocular, Barcelona, Spain. guell@imo.es
José Luis
JL
Güell
Merce
M
Morral
Oscar
O
Gris
Javier
J
Gaytan
Maite
M
Sisquella
Felicidad
F
Manero
D000065:Accommodation, Ocular / Q000502:physiology*; D000328:Adult; D000867:Anterior Chamber / Q000601:surgery*; D002452:Cell Count; D004728:Endothelium, Corneal / Q000473:pathology; D006801:Humans; D007498:Iris / Q000601:surgery; D019654:Lens Implantation, Intraocular / Q000379:methods; D007908:Lens, Crystalline / Q000502:physiology*; D007910:Lenses, Intraocular; D008875:Middle Aged; D009216:Myopia / Q000601:surgery*; D019904:Polymethyl Methacrylate; D011680:Pupil / Q000502:physiology; D041623:Tomography, Optical Coherence / Q000379:methods*
D019904:Polymethyl Methacrylate