Age-corrected reference values for the Heidelberg multi-color anomaloscope.

BACKGROUND: To determine reference values for the HMC anomaloscope (Heidelberg multi-color anomaloscope) of healthy subjects. METHODS: One hundred and thirteen healthy subjects were divided into four age groups: <20 years of age (ten female, five male), 20-39 years of age (23 female, 15 male), 40-59 years of age (23 female, ten male) and >60 years of age (nine female, 18 male). Match midpoint, matching range (MR) and anomaly quotient (AQ), according to the Moreland equation [blue (436 nm) + blue-green (490 nm) = cyan (480 nm) + yellow (589 nm)] and according to the Rayleigh equation [green (546 nm) + red (671 nm) = yellow (589 nm)] were determined. The neutral adaptation was done showing white light every 5 seconds in absolute mode and every 15 seconds in relative mode. RESULTS: The mean match midpoint according to the Rayleigh equation was 43.9 ± 2.6 scale units in absolute mode. It was highest between 20-39 years (45.2 ± 2.2) and lowest in subjects >60 years of age (42.2 ± 2.2). The mean MR in absolute mode was 3.1 ± 3.5 scale units with a maximum >60 years (4.4 ± 4.4). The MR in relative mode was between 1.6 ± 1.9 (20-39 years) and 4.4 ± 3.8 (>60 years). The resulting mean AQ was 1.01 ± 0.15 in both modes. The mean match midpoint of the Moreland equation was 51.0 ± 5.2 scale units in absolute mode. It was highest between 20-39 years (52.5 ± 5.7), and lowest in subjects >60 years of age (48.7 ± 3.6). The mean MR according to the Moreland equation was lower in absolute mode (13.4 ± 15.6) than in relative mode (16.2 ± 15.2). The mean resulting AQ was 1.02 ± 0.21 in both modes. CONCLUSION: The values of this study can be used as references for the diagnosis of red-green and blue perception impairment with the HMC anomaloscope.

Changes of the accommodative amplitude and the anterior chamber depth after implantation of an accommodative intraocular lens.

BACKGROUND: Modern cataract surgery is interested in recovery of the accommodative power. This investigation aimed at determining pseudophakic accommodation in subjects implanted with the accommodative Human Optics 1 CU intraocular lens after drug-induced ciliary muscle stimulation by measuring the objective refraction and the changes in anterior chamber depth in comparison with a PMMA intraocular lens with rigid haptics. METHODS: The studied sample involved 30 eyes of 30 patients undergoing cataract surgery due to age-related cataract. Patients were between 50 and 77 years of age (67.71 +/- 8.0). No randomization was performed. The 1 CU accommodative intraocular lens and the PMMA intraocular lens were implanted in 15 eyes of patients with an expected visual acuity of at least 0.7. Objective refraction under pilocarpine-stimulated ciliary muscle contraction was determined with a Hartinger coincidence refractometer. The anterior chamber depth was measured with Jäger's Haag-Streit slit-lamp attachment. The accommodative amplitude and the anterior chamber flattening were calculated from the measured values. RESULTS: Twelve weeks after surgery the average accommodative amplitude in eyes with a 1 CU intraocular lens calculated from the refractive change under drug-induced stimulation was 0.48 +/- 0.36 D (with a maximum of 1.25 D). The measured change of anterior chamber depth under drug-induced stimulation was 0.3 +/- 0.32 mm (at a maximum of 0.9 mm). In the reference group with PMMA lenses, the mean accommodative amplitude derived from the refractive changes under drug-induced stimulation was 0.34 +/- 0.27 D (at a maximum of 0.85 D). The measured change in anterior chamber depth under drug-induced stimulation was 0.18 +/- 0.09 mm (at a maximum of 0.31 mm). No statistically significant differences were found between the two groups of lenses concerning change in anterior chamber depth and accommodative amplitude. CONCLUSIONS: This investigations indicate a mean anterior 1 CU shift of only 0.32 mm and a maximum of 0.9 mm. The accommodative amplitudes measured with the Hartinger coincidence refractometer (mean value 0.47 D) correspond to these values. Similar conclusions may be drawn from existing investigative results of the reference group, which are on the same order of magnitude as those of the 1 CU group. Objective accommodation measurements are needed to evaluate commercially available accommodative intraocular lenses in a scientifically satisfactory manner. Objectively measurable parameters include changes of the anterior chamber depth as well as refraction, as determined for instance by coincidence refractometry and streak retinoscopy. Future studies should also consider the IOL properties, astigmatism, and pupillary diameter. This is the only way to identify pseudoaccommodation and a decisive factor for further development of accommodative artificial lenses.