title: Optical coherence tomography of the anterior segment in eyes with phakic refractive lenses.
abstract: OBJECTIVE
  To evaluate the dynamics of the phakic refractive lens (PRL) in myopic and hyperopic eyes in the nonaccommodated state and during subjective accommodation with Visante optical coherence tomography (OCT).
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Forty-one myopic eyes and 11 hyperopic eyes of 52 patients (mean age, 34 years; range, 24-49) were examined at least 1 year after PRL implantation using Visante OCT. Thirty-one myopic eyes had the PRL model 101 and 10 eyes had the smaller PRL model 100 implanted. The hyperopic model, PRL 200, is available in only one size.
  
  
  METHODS
  Noninvasive high-resolution anterior OCT was used to measure distance changes between the PRL and adjacent intraocular structures in the nonaccommodative state (baseline) and during accommodation.
  
  
  METHODS
  Mean distance changes from the anterior lens surface (ALS) to the PRL and from the corneal posterior surface to the ALS and the PRL, and changes in the pupil diameter.
  
  
  RESULTS
  At baseline, the mean distances between the PRL and crystalline lens were 0.38, 0.30, and 0.32 mm for the PRL 101, PRL 100, and PRL 200, respectively. The PRLs were significantly closer to the crystalline lens with increasing patient age. Three PRLs were in contact with the crystalline lens (6%), and there were lens opacities in 2 of these eyes. During accommodation, the ALS of all PRL models showed significant forward movement (P<0.05), whereas the distance between the PRL and crystalline lens decreased significantly with the PRL 101 and PRL 200 (P<0.05). The distance between the PRL 100 and crystalline lens remained unchanged during accommodation.
  
  
  CONCLUSIONS
  The PRL moved forward during accommodation in all eyes, with the distance preserved between the PRL and the ALS with the PRL 100. The distance decreased with the other 2 models. In 85% of cases, there was no mechanical contact with the ALS during accommodation.
authors.affiliation: Anterior Segment Department, St. Erik's Eye Hospital, and Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden. annemari.koivula@sankterik.se
authors.forename: Annemari
authors.initials: A
authors.lastname: Koivula
authors.forename: Maria
authors.initials: M
authors.lastname: Kugelberg
mesh_terms: D000065:Accommodation, Ocular / Q000502:physiology; D000328:Adult; D000869:Anterior Eye Segment / Q000473:pathology*; D003430:Cross-Sectional Studies; D006801:Humans; D006956:Hyperopia / Q000601:surgery*; D019654:Lens Implantation, Intraocular; D007908:Lens, Crystalline / Q000502:physiology; D007910:Lenses, Intraocular; D008875:Middle Aged; D009216:Myopia / Q000601:surgery*; D011680:Pupil / Q000502:physiology; D012029:Refraction, Ocular / Q000502:physiology; D041623:Tomography, Optical Coherence