Accommodation in pseudophakic eyes

PurposeToday, many patients who have undergone cataract surgery want to enjoy good non-spectacle corrected distant vision and nonspectacle corrected near vision with glasses independence. According to the literature, the implantation of an accommodative intraocular lens (AIOLs) can achieve the level of vision after cataract surgery. However, there is a debate regarding the true accommodative capability of the AIOLs (i.e., whether the IOLs can move forward when attempting to accommodate like the natural crystalline lens of a phakic eye). This review aims to answer the following questions: (1) Can pseudophakic eye accommodate? (2) If pseudophakic eyes can accommodate, how long does this accommodation last? (3) Is there pseudoaccommodation?MethodsThis is a systematic review of randomized and nonrandomized controlled trials that have compared different IOLs in accommodation using subjective and objective methods of testing accommodation. All peer reviewed randomized and nonrandomized controlled trials that compared different IOLs in accommodation were included.ResultsThere was evidence of pseudophakic accommodation up to 12 months postoperatively for AIOLs (mostly 1CU): subjective accommodation [95% confidence interval (CI), 0.36–0.98], objective optic shift (95% CI, 0.12–0.76). However, accommodation decreased at 12 months postoperatively (95% CI, 0.55–1.00). In addition, several papers have reported evidence of pseudoaccommodation.ConclusionThere is pseudophakic accommodation up to 1 year post cataract surgery, mostly 1CU AIOL. Pseudoaccommodation may coexist.