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This article will explore the available accommodative technologies under these 3 headings including any limitations concerning lens excursion and accommodative amplitude and examine the potential impact of these IOLs on cataract and refractive surgeons and patients.
The Morcher Bio Com Fold Type 43E, Human Optics 1 CU, Lenstec Tetra Flex, and eyeonics crystalens are examples of single-optic IOLs.
Single-optic, accommodating IOLs function by changing their position in the capsular bag during accommodative effort with a resulting increase in the effective power but not the inherent power of the lens.
The limitations of these IOLs stem from their inability to move significantly enough to generate large amplitudes of accommodative power that would yield consistently acceptable near visual acuities.
Not only will this enhance cataract surgery results, but it will also enable refractive surgeons to offer their patients a procedure that is unhindered by the restrictions of corneal refractive surgery and presbyopia.
Accommodating lenses can currently be classified into 3 categories: (1) single-optic, (2) dual-optic, (3) and deformable optic IOLs.
The Medennium Smart IOL is a hydrophobic, acrylic IOL that has dimensions (9.5 x 3.5 mm) similar to the natural crystalline lens.
Both of these IOLs utilize a positively powered biconvex front lens connected to a negatively powered concave-convex lens.The Human Optics 1CU is a hydrophilic, acrylic, foldable, single-piece lens with a biconvex square-edge optic and 4 modified flexible haptics that allow for forward movement of the optic during accommodative effort (Figure 1).In a similar study as that performed with the Morcher Bio Comfold IOL, median anterior movement of the Human Optics 1CU after pilocarpine 2% instillation was calculated to result in a refractive change of no more than 0.5 D in most patients 2004;115-1521).During accommodative effort, the 2 lens components increase their distance from each other, resulting in increased effective power of the overall lens.The dual-optic design offers potential advantages over single-optic designs in that less lens excursion is necessary with the dual-optic in order to achieve a desired amount of accommodation (Figure 3) 2003;84-2287).