Accommodative lens outcomes less than stellar

Orlando-An evaluation of 4 randomized clinical trials found no evidence to recommend the use of accommodative IOLs, said Hon Shing Ong, MBBS.

Participants who received accommodative IOLs had improvements in near vision at 6 months and at 12 months after surgery, compared with those who received monofocal IOLs.

“(But) such improvements were small and reduced with time,” said Dr. Ong, Moorfields Eye Hospital, London.

Dr. Ong’s group searched the Cochrane Central Register of Controlled Trials, and found 256 eyes (148 in the accommodative group and 108 in the monofocal group). All eyes that received an accommodative lens were implanted with the HumanOptics 1CU.

Compared with the monofocal group, the accommodative IOL group had significantly higher amplitude of accommodation at 6 months post treatment measured by near point of accommodation (mean difference [MD] 1.43 D; 95% CI 0.79 to 2.07) and defocus curves (MD 0.47 D; 95% CI 0.36 to 0.59).

“At 12 months, patients in the accommodative group had worse corrected distance visual acuity than those in the monofocal group,” he said. “There was a higher rate of posterior capsular opacification (PCO) in the accommodative group.”

The lower levels of distance vision may be related to the increased PCO, but findings were not definitive, Dr. Ong said.

“The small gains in distance corrected visual acuity were not clinically significant,” he said. “Further research is necessary before we can draw conclusions on accommodative lens efficacy and safety compared with monofocal IOLs.”

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