Analysis of Accommodative Performance of a New Accommodative Intraocular Lens.

PURPOSE: To compare objective and subjective accommodation and visual acuities with a new accommodative intraocular lens (IOL) (Lumina; AkkoLens Clinical BV, Rijswijk, The Netherlands) with a monofocal IOL and young phakic eyes. METHODS: In this prospective, randomized controlled clinical investigation, patients aged 51 to 85 years with symptomatic cataract were enrolled in the study. A total of 25 eyes were implanted with the accommodative IOL and 18 eyes received the monofocal Acrysof SA60AT IOL (Alcon Laboratories, Inc., Fort Worth, TX). Each group included 4 bilateral patients. An additional 20 phakic eyes of young patients aged 19 to 29 years were used to assess the restoration of accommodation. Subjective and objective accommodative amplitudes were evaluated by defocus curves and the WAM-5500 open-field Auto Ref/Keratometer (Grand Seiko, Tokyo, Japan), respectively. RESULTS: The 1-year postoperative examination showed significantly better visual acuities with the accommodative IOL compared to the monofocal IOL, over a defocus range of -0.50 to -5.00 diopters (D) (P < 10-5), and revealed more than 50% of the visual acuities of the young phakic eyes at up to -3.50 D defocus. The depth of focus of the accommodative group exceeded that of the monofocal group by 2.52 ± 0.03 D in a visual acuity range of 0.3 to 0.8 (decimal) (20/63 to 20/25 Snellen). Compared with the monofocal IOL, the accommodative IOL resulted in a similar uncorrected distance visual acuity of 0.99 ± 0.12 (20/20 Snellen) (P > .79) and a significantly better uncorrected near visual acuity of 0.91 ± 0.11 (20/22 Snellen) (P < 2.7 × 10-6). A significant correlation of 0.51 (P < 1.3 × 10-7) was found between the objective and subjective accommodative amplitudes with the accommodative IOL. CONCLUSIONS: Eyes implanted with the accommodative IOL showed similar amounts of objective and subjective accommodation. [J Refract Surg. 2018;34(2):78-83.].

Visual Outcomes and Accommodative Response of the Lumina Accommodative Intraocular Lens.

PURPOSE: To compare visual acuity, accommodation, and contrast sensitivity of the AkkoLens Lumina accommodative intraocular lens (AkkoLens Clinical b.v., Breda, The Netherlands) with a standard monofocal intraocular lens (IOL). DESIGN: Randomized clinical trial. METHODS: The study enrolled 86 eyes with cataract that all required cataract surgery and IOL implantation. The study group included 61 eyes that were implanted with the Lumina. The control group included 25 eyes that were implanted with an Acrysof SA60AT (Alcon, Fort Worth, TX, USA) monofocal IOL. The distance and near visual acuities, contrast sensitivity, and accommodation were measured over a 1-year follow-up period. Accommodation was measured subjectively, using defocus curves, and objectively, with an open-field autorefractor. RESULTS: Uncorrected (UDVA) and corrected (CDVA) distance visual acuities did not differ significantly between the groups (P ≥ .21) over the 12 months. However, the uncorrected near visual acuity (UNVA) was 0.07 ± 0.08 logRAD for the Lumina group and 0.37 ± 0.19 logRAD for the control group (P < .01) and the corrected distance near visual acuity (CDNVA) was 0.11 ± 0.12 LogRAD for the Lumina group and 0.41 ± 0.15 LogRAD for the control group (P < .01). Defocus curves showed a statistically significant difference between groups for defocus ranging from -4.50 to -0.50 diopters (D) (P < .01) with significantly higher visual acuities for the Lumina group. Subjective accommodation, as determined from defocus curves, was 3.05 ± 1.06, 3.87 ± 1.27, and 5.59 ± 1.02 D for the Lumina group and 1.46 ± 0.54, 2.00 ± 0.52, and 3.67 ± 0.75 D for the control group at visual acuities of 0.10, 0.20, and 0.4 logMAR for both groups, respectively. The objective accommodation, measured by an open-field autorefractor, was 0.63 ± 0.41, 0.69 ± 0.45, 0.91 ± 0.51, and 1.27 ± 0.76 D for the Lumina group and 0.10 ± 0.15, 0.12 ± 0.15, -0.06 ± 0.09 and 0.07 ± 0.10 D for the control group at accommodation stimuli of 2.0, 2.5, 3.0, and 4.0 D, respectively. Contrast sensitivity was the same for both groups (P ≥ .26). CONCLUSIONS: The Lumina accommodative IOL effectively restores the visual function, accommodation, and contrast sensitivity after cataract surgery with no influence on the postoperative contrast sensitivity.