Pseudophakic accommodation with 2 models of foldable intraocular lenses

Purpose To evaluate the amplitude of pseudophakic accommodation of 2 foldable intraocular lenses (IOLs) by measuring the anterior chamber depth (ACD) shift during a 1-year follow-up. Setting Department of Ophthalmology, Medical and Health Science Center, University of Debrecen, Debrecen, Hungary. Methods This prospective study comprised 44 eyes of 44 cataract patients operated on with phacoemulsification and in-the-bag implantation of Akreos Disc (22 eyes) or AcrySof MA60BM (22 eyes) IOLs. The ACD was measured by A-scan during fixation at 30 cm and again after instillation of cyclopentolate 1%. The ACD shift was calculated by subtracting the ACD under cyclopentolate from the ACD during fixation at 30 cm. Follow-up measurements were performed 3, 6, and 12 months after surgery. Statistical analysis concerning the difference between the 2 groups was done by the Student unpaired t test. Results The ACD shift was greater in the AcrySof group than in the Akreos Disc group at all 3 follow-up examinations. The difference was highly significant between the 2 groups at 6 and 12 months (both P = .004). After the operation, the ACD shift increased continuously with time in both groups. The mean ACD shift reached 0.57 mm ± 0.25 (SD) in the AcrySof group and 0.42 ± 0.24 mm in the Akreos group at 12 months. Conclusions The 3-piece AcrySof MA60BM IOL with 10-degree posterior angulation had a significantly higher capacity for pseudophakic accommodation than the 1-piece plate-haptic Akreos Disc IOL. The continuous increase in the ACD shift in the postoperative period may mean that patients learn to achieve better accommodation with an IOL as time goes on.