VIENNA — Despite the limited success obtained by previous models, accommodating IOLs are not a dead concept. A new generation of accommodating lenses may, in fact, be the future of presbyopia correction, according to one specialist.
“Once accommodative IOLs are developed adequately, multifocal IOLs will be unable to compete,” Jorge L. Alió, MD, PhD, said at the meeting of the European Society of Ophthalmology.
Jorge L. Alió
Multifocality has greatly improved and gained success in recent years, but it is not a physiological concept.
“Multifocal optics will always require some degree of adaptation,” Alió said.
New accommodating IOL models include in-the-bag technologies, such as the FluidVision (PowerVision) and the Sapphire (Elenza), as well as in-the-sulcus models, such as the DynaCurve (NuLens) and the Lumina (Akkolens/Oculentis).
Sulcus-implanted lenses are a better concept, according to Alió, because the capsular bag naturally develops fibrosis and atrophy once it is emptied, and there are no functions and no anatomical reasons for it to exist.
“The structural source of kinetic energy is the anterior capsule, which generates axial, centripetal and centrifugal forces that we can exploit to re-establish accommodation,” he said.
In the Lumina lens, power changes are produced by two elements shifting in the plane perpendicular to the optical axis. In a pilot study, the lens was implanted in 50 eyes, and results were compared with those of a standard monofocal IOL.
“The lens showed good results, with evidence of accommodation between 1.5 D and 6 D by objective WAM measurements and subjective defocus curve at 6 months,” Alió said.
He showed the video of a patient who was able to see 20/20 at distance and at the same time read small print on a smartphone. – by Michela Cimberle
Disclosure: Alió reports he is a consultant to Akkolens and Oculentis.