Functional Assessment of Two Different Accommodative Intraocular Lenses Compared with a Monofocal Intraocular Lens

PurposeTo evaluate selected functional and physical properties of 2 models of accommodative intraocular lenses (IOLs) compared with those of a standard monofocal IOL.DesignProspective randomized comparative trial.ParticipantsSubjects were divided into 3 groups. In group 1, 30 eyes (19 subjects) received 1CU IOL implantation; in group 2, 29 eyes (19 subjects) received AT-45 IOL implantation; and in group 3, 21 eyes (21 subjects) were implanted with a monofocal IOL as a control.InterventionCataract surgery with implantation of the 1CU and AT-45 accommodative IOL models in the study groups, and the ACR6D monofocal IOL in the control group.Main Outcome MeasuresFar and near distance visual parameters were assessed at 1, 6, and 12 months after surgery in the accommodative IOL groups, and at 1 and 12 months in the control group. Anterior segment anatomy was investigated by ultrasound biomicroscopy, with and without visual accommodative stimulation.ResultsThe accommodative IOL groups significantly differed from the controls in terms of lower near-distance refractive addition (NDRA) and better distance-corrected near visual acuity (DCNVA), with P<0.001 at 1 year. The anterior IOL displacement during accommodation (ΔACD) was significantly larger in the study groups, and this correlated with DCNVA. Until 6 months, the ΔACD correlated with the solicited sclerociliary process rotation only in the study groups.ConclusionThis 12-month study demonstrated that the accommodating IOLs achieved better clinical results than the monofocal IOL in terms of DCNVA and NDRA. These results support the hypothesis that accommodative IOLs proportionally react to ciliary body rotation, although this relationship became less evident at 12 months.