Single-optic positional accommodating intraocular lenses: a review

Abstract

Presbyopia is an age-related physiological condition that causes a gradual loss in the ability to focus on near objects, secondary to changes in zonular fibers, ciliary muscle and crystalline lens. Different surgical approaches are being pursued to surgically compensate presbyopia, such as corneal techniques or implantation of multifocal intraocular lenses (IOLs); however, their inability to restore accommodation has led to the development of single-optic positional accommodative IOLs. The axial shift, with the contraction of the ciliary muscle, of these IOLs increases the refractive power of the eye, improving the level of uncorrected near vision. Single-optic positional accommodative IOLs present few disturbances and larger ocular aberrations that improve near vision. However, reduced amplitudes of accommodation are obtained, little IOL shifts are measured and overall visual outcomes are limited.

Keywords::

• accommodation
• intraocular lenses
• presbyopia

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Key issues

• Single-optic positional accommodating intraocular lenses (IOLs) provide good distance visual outcome, with a relatively predictable correction of the refractive error.

• Single-optic positional accommodating IOLs do not deteriorate significantly the visual quality, preserving the levels of contrast sensitivity.

• The shift of the single-optic positional accommodating IOL is insufficient to restore near and even intermediate vision with some models.

• The results of single-optic positional accommodating IOLs is very dependent on the dimensions of the eye and the corneal power and therefore may be not useful in some cases.