NuLens presents a new concept for an accommodating IOL

With some of the leading ophthalmic surgeons and researchers from Europe and the United States in attendance, NuLens Ltd. introduced a new concept of accommodative IOLs for the treatment of presbyopia during an off-site presentation at the European Society of Cataract and Refractive Surgeons meeting.

Joshua Ben-Nun, MD, chief medical officer for NuLens, Herzliya, Israel, outlined the company's efforts in developing an accommodating IOL with over 10 D of accommodative power. His research, based on Dr. Ben-Nun's patents and trials on rhesus monkeys, has established proof of the concept and confirmed data of over 30 D of accommodation for the lens, reported Dr. Ben-Nun.

According to the company, the concept of the novel IOL operates on the basic physical principles of the human eye. The lens is implanted following a normal cataract removal, differing only in that the lens capsule is allowed to collapse, creating a "capsular diaphragm" that reaches from the ciliary process through zonuli, collapsed lens capsule, zonuli, and ciliary process again. The lens, having an anterior reference plane and posterior aperture near the nodal point, is implanted.

The lens is placed with internal sclera fixation (not sutured) in the ciliary sulcus and angled, via patented haptics, toward the capsular diaphragm. There is a small chamber in the lens that is filled with a silicone gel and a posterior "piston" with an aperture in its center. The piston allows for the silicone to bulge in accordance with the forces generated by the capsular diaphragm. The process thus simulates the actions of the muscles responding to the naturally occurring "blur stimulus" for the accommodation of the brain, said Dr. Ben-Nun.

NuLens expects the development of this technology will lead to the development of "a real accommodating IOL" with the unparalleled capacity of providing 10 diopters of "real accommodative power" in humans, Dr. Ben-Nun said.

Although the developmental efforts of the technology is supported by I. Howard Fine, MD, Richard Lindstrom, MD, David Apple, MD, Douglas Koch, MD, (all of the United States), Jorge Alio, MD, (Spain), and Emanuel Rosen, MD (United Kingdom), some members of the audience expressed some concerns, ranging from fatigue to a concern that the lens would not be viable based on basic principles of accommodation. Dr. Ben-Nun pointed out that the technology is new and that many issues still need to be addressed before the technology comes to market.