Accommodation amplitudes after an accommodating intraocular lens refilling procedure: in vivo update.
OBJECTIVE
To evaluate whether a new capsular bag-refilling procedure provides some accommodation in monkey eyes and to assess the difference in accommodation with different volumes of capsular bag refilling.


METHODS
Jinshikai Medical Foundation, Nishi Eye Hospital, Osaka, Japan.


METHODS
Experimental study.


METHODS
A central 3.0 to 4.0 mm continuous curvilinear capsulorhexis was created, after which phacoemulsification was performed in the usual manner. A new accommodating-membrane intraocular lens (IOL) for sealing the capsular opening was implanted in the capsular bag. Silicone polymers were injected beneath the IOL into the capsular bag through the delivery hole. In 3 study groups, each with 6 monkey eyes, the lens capsule was refilled with 0.080 mL of silicone polymers, corresponding to a 65% bag volume; 0.100 mL, corresponding to an 80% bag volume; or 0.125 mL, corresponding to a 100% bag volume. To calculate the accommodation amplitudes achieved, automated refractometry was performed before and 1 hour after topical pilocarpine 4.0% application preoperatively and 4 weeks postoperatively.


RESULTS
The refilling technique was successful without polymer leakage in all monkeys. Four weeks after surgery, the mean accommodation amplitudes were 2.56 diopters (D) ± 0.74 (SD), 2.42 ± 1.00 D, and 2.71 ± 0.63 D, respectively, in the 3 study groups.


CONCLUSIONS
The technique provided some accommodation in young monkey eyes. Leakage of the injectable silicone polymers and anterior capsule opacification in the visual axis were avoided. The results suggest that the capsular bag-refilling procedure warrants further study for possible clinical application.


BACKGROUND
All authors have a proprietary interest in the accommodating membrane IOL mentioned in the article.
From the Jinshikai Medical Foundation (O. Nishi, Y. Nishi, K. Nishi), Nishi Eye Hospital, Osaka, Japan; Calhoun Vision Institute (Chang), Pasadena, California, USA. Electronic address: okihiro@nishi-ganka.or.jp.
Okihiro
O
Nishi
From the Jinshikai Medical Foundation (O. Nishi, Y. Nishi, K. Nishi), Nishi Eye Hospital, Osaka, Japan; Calhoun Vision Institute (Chang), Pasadena, California, USA.
Yutaro
Y
Nishi
From the Jinshikai Medical Foundation (O. Nishi, Y. Nishi, K. Nishi), Nishi Eye Hospital, Osaka, Japan; Calhoun Vision Institute (Chang), Pasadena, California, USA.
Shiao
S
Chang
From the Jinshikai Medical Foundation (O. Nishi, Y. Nishi, K. Nishi), Nishi Eye Hospital, Osaka, Japan; Calhoun Vision Institute (Chang), Pasadena, California, USA.
Kayo
K
Nishi
D000065:Accommodation, Ocular / Q000502:physiology*; D000818:Animals; D019923:Capsulorhexis; D032801:Iridectomy; D007903:Lens Capsule, Crystalline / Q000187:drug effects* / Q000601:surgery; D019654:Lens Implantation, Intraocular / Q000379:methods*; D007910:Lenses, Intraocular; D008252:Macaca fascicularis; D018918:Phacoemulsification; D010781:Photography; D012029:Refraction, Ocular / Q000502:physiology; D012828:Silicones / Q000008:administration & dosage*; D016896:Treatment Outcome
D012828:Silicones; C078211:polymethylsiloxane