Meta-analysis of accommodating intraocular lenses

Accommodating intraocular lenses (IOLs) based on the concept of optic shift were introduced to restore accommodation after cataract surgery. Currently, 3 types of accommodating IOLs are commercially available: 1CU (HumanOptics), BioComFold (Morcher), and AT-45 Crystalens (eyeonics, Inc.). We present a meta-analysis of the peer-reviewed data from studies of these IOLs that use optic-shift measurements and visual acuity as the main outcome measures. In the 6 randomized controlled studies, 5 of which studied the 1CU IOL, the visual acuity results showed moderate to no improvement in near visual acuity compared with control IOLs and a statistically significant but small and inter-patient variable anterior shift of the IOL optic after pilocarpine stimulation. More clinical trials with randomized, controlled, and patient- and examiner-masked study designs that follow the guidelines of evidence-based medicine are needed to prove a benefit of accommodating focus-shift IOLs.