Accommodating lens model continues trend of improved outcomes throughout implant evolution

A fourth-generation version of an accommodating IOL (HD-100 crystalens, eyeonics) providesexcellent uncorrected visual acuity (UCVA) at all distances without degrading contrast acuity,according to the results of an FDA multicenter clinical trial presented by John A. Hovanesian,MD.

The lens has been designed on the platform of the company's existing IOL (AT-50 crystalens) with a proprietaryoptic design modification that still maintains a single retinal image but is intended to increase theimplant's effective focal range. However, the lens evaluated in the multicenter trial was built onthe previous platform.

Monocular visual acuity was measured at distance, intermediate (32 inches), and near (16 inches)without correction and through best distance correction. Considering data from patients who fellwithin 0.5 D of intended target (a subgroup of specific interest to the FDA review), UCVA was 20/30or better in 86% of eyes for distance, 20/20 or better at intermediate in more than 80% of eyes, andJ2 or better at near in 80%. Through distance correction, 83% of eyes achieved 20/20 or better inintermediate testing and 70% saw J2 or better at near. Compared with eyes with the existing version of the lens implanted,recipients of the new lens had similar results in mesopic contrast sensitivity testing with and withoutglare.

"The evolution of the crystalens has been going on for nearly 2 decades with steady improvements indesign and good acceptance of the current model. However, surgeons still need to target mildmyopia in the non-dominant eye to provide spectacle independence, and we would prefer not to have todo this," Dr. Hovanesian said. "The vision outcomes achieved with this latest version of the [lens] are an improvement uponthose associated with the currently approved models and we hope this new lens will be released towardthe end of 2008."

Dr. Hovanesian is featured in Ophthalmology Times' AAO Podcast Series. To listen to aninterview with Dr. Hovanesian, click here.