Effects of accommodation training on accommodation and depth of focus in an eye implanted with a crystalens intraocular lens.
OBJECTIVE
To investigate objective measures of the effects of accommodative training of a pseudophakic eye implanted with a Crystalens AT-52SE (eyeonics Inc) intraocular lens (IOL) on reading performance, accommodation, and depth of focus.


METHODS
Objective dynamic measures of accommodation, pupil size, and depth of focus were quantified from wavefront measures before and after 1 week of accommodative training that began 29 months after implantation of an accommodating IOL in one patient. Depth of focus was estimated from 50% cut-off of peak performance levels for defocus curves that were computed from the image quality metric VSOTF based on ocular wavefront aberrations.


RESULTS
The patient reported improved near vision reading performance after completing the training procedure. After training, there was a shift in conjugate focus in the hyperopic direction, yet the depth of focus increased significantly for near objects. Simulated retinal images and the calculated modulation transfer function of the eye both demonstrated improved quality for near vision after training.


CONCLUSIONS
The subjective report of improved near vision after training was correlated with improvement of objective measures. Depth of focus increased for near objects with attempts to accommodate after training. This change was linked to increases in aberrations and pupil size and occurred despite the conjugate focus shifting in the hyperopic direction. These results demonstrate that accommodative training may be useful in improving near vision in patients with accommodating IOLs.
School of Optometry, University of California at Berkeley, California, USA.
Humza J
HJ
Tahir
Jian L
JL
Tong
Sydney
S
Geissler
Indu
I
Vedamurthy
Clifton M
CM
Schor
D000065:Accommodation, Ocular / Q000502:physiology*; D000221:Adaptation, Ocular / Q000502:physiology; D003867:Depth Perception / Q000502:physiology*; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular; D008875:Middle Aged; D011474:Prosthesis Design; D011932:Reading; D012029:Refraction, Ocular / Q000502:physiology; D012160:Retina / Q000502:physiology; D014792:Visual Acuity / Q000502:physiology