Objective measurement of accommodation in patients with an accommodating intraocular lens compared to phakic, presbyopic, and pseudophakic eyes

IF 3 3区医学 Q1 OPHTHALMOLOGY

Acta Ophthalmologica Pub Date : 2025-01-19 DOI:10.1111/aos.17278

Timo Eppig, Manuel Seer, Violetta Müller, Saskia Schütz, Michiel Rombach, Willem van Lawick

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引用次数: 0

Abstract

Aims/Purpose: The restoration of accommodation after cataract surgery remains to be one of the biggest challenges in ophthalmology. Numerous concepts for restoration of accommodation have failed due to a lack of objective accommodation measurement. The purpose of this study was to demonstrate the dynamic pseudophakic accommodation in patients with an accommodative AIOL by means of an objective accommodation measurement and to compare the data with a young phakic, a presbyopic and a monofocal pseudophakic person.

Methods: We included 3 patients in the study who had a Lumina AIOL implanted in both eyes. All patients had completed at least the 6 month follow-up. In addition, we included both eyes of 3 comparative persons with different status of the lens (phakic, presbyopic and pseudophakic). We used a binocular open-field videorefractor (PowerRef 3, Plusoptix GmbH, Germany) to measure the change of refraction, pupil diameter and ocular convergence while patients were asked to focus on an ETDRS chart. The ETDRS chart was then continuously moved from 6m distance to 33 cm distance while the patients were asked to focus on a single letter. The resulting curves were then compared to demonstrate the objective change in refraction.

Results: The data exhibit a continuous change of binocular refraction which follows the pupil constriction and decrease of pupil distance (convergence) in the young phakic person and the AIOL patients. The maximum accommodative change was up to 2.5 D in the AIOL patients and up to 3 D in the young phakic person for a stimulus distance of 33 cm. The presbyopic patient and the monofocal pseudophakic patient showed pupil constriction and convergence but the accommodative range was less pronounced with a maximum change of 1 D.

Conclusions: The PowerRef 3 allows for an objective proof of pseudophakic accommodation in patients with an AIOL. AIOL eyes show defined change of refractive power that can be maintained constant for the time of fixation to a near target compared to presbyopic and monofocal pseudophakic eyes that show only little modulation, which can be attributed to pseudo-accommodative effects.

查看原文本刊更多论文

与晶状体、老花眼和假性晶状体相比，人工晶状体调节的客观测量

目的/目的：白内障术后调节功能的恢复一直是眼科面临的最大挑战之一。由于缺乏客观的住宿测量，许多恢复住宿的概念都失败了。本研究的目的是通过客观的调节测量来证明可调节AIOL患者的动态假性晶状体调节，并将数据与年轻的晶状体患者、老花眼患者和单焦假性晶状体患者进行比较。方法：本研究纳入3例双眼植入Lumina AIOL的患者。所有患者均完成了至少6个月的随访。此外，我们还纳入了3名不同晶状体状态（晶状体、老花眼和假性晶状体）的对照者的双眼。我们使用双目开视野视频屈光仪（PowerRef 3, Plusoptix GmbH, Germany）来测量屈光、瞳孔直径和眼球会聚的变化，同时要求患者聚焦在ETDRS图表上。然后，ETDRS图表从6米的距离连续移动到33厘米的距离，同时要求患者专注于一个字母。然后将所得曲线进行比较，以证明客观折射的变化。结果：年轻晶状体患者和AIOL患者的双眼屈光度随瞳孔收缩和瞳孔距离（会聚）减小而发生连续变化。在刺激距离为33 cm的情况下，AIOL患者的最大调节变化可达2.5 D，年轻有晶状体的患者可达3 D。老视眼患者和单焦点假性晶状体患者均表现出瞳孔收缩和会聚，但调节范围较弱，最大变化为1 d。结论：PowerRef 3可以客观证明AIOL患者的假性晶状体调节。与老花眼和单焦假性眼睛相比，AIOL眼睛的屈光能力变化明显，在固定到近目标的时间内可以保持恒定，而屈光能力变化很小，这可归因于伪调节效应。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta Ophthalmologica 医学-眼科学

CiteScore

7.60

自引率

5.90%

发文量

433

审稿时长

6 months

期刊介绍： Acta Ophthalmologica is published on behalf of the Acta Ophthalmologica Scandinavica Foundation and is the official scientific publication of the following societies: The Danish Ophthalmological Society, The Finnish Ophthalmological Society, The Icelandic Ophthalmological Society, The Norwegian Ophthalmological Society and The Swedish Ophthalmological Society, and also the European Association for Vision and Eye Research (EVER). Acta Ophthalmologica publishes clinical and experimental original articles, reviews, editorials, educational photo essays (Diagnosis and Therapy in Ophthalmology), case reports and case series, letters to the editor and doctoral theses.