Accommodating lenses

The eyeonics crystalens is a 10.5 mm, hinged plate haptic silicone lens with a 4.5 mm optic (Figure 2).

It is the only accommodating IOL that has been approved by the FDA.

A more recent study further questioned the validity of this lens’s mechanism of action by demonstrating a mean 151 micron backward shift of the crystalens with pilocarpine 2% instillation Despite a lack of evidence supporting substantial axial movement of the crystalens, data from FDA clinical trials revealed that 26% of patients implanted bilaterally with this IOL were able to function completely without glasses, and 74% of patients were able to function either completely or mostly without glasses.

Yet, despite a mean accommodative amplitude of 1.08 ± 0.54 D (range 0-2.25), 86% of patients in this study required no correction for near vision during routine daily activities.After being placed in the aqueous at body temperature, the Medennium Smart IOL transforms into a soft gel that completely fills the capsular bag and maintains some elasticity.The AMO Flex Optic IOL is an accommodating IOL that fills or conforms to the capsular bag and is designed to increase its anterior radius of curvature (and true power) in addition to changing its position in the capsular bag during accommodative effort.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.

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Initial reports of close to 100 eyes implanted with this lens have demonstrated that more than 95% of eyes have accommodative amplitudes of more than 1 D, 70% have more than 2 D, and 20% have more than 3 D.

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