Initial experience with an accommodating intraocular lens: Controlled prospective study

PURPOSE: To evaluate the outcomes of implantation of an accommodating intraocular lens (IOL) in pseudophakic presbyopic eyes. SETTING: Ophthalmology Department, Benha Medical School, Benha, Egypt. METHODS: In this prospective controlled trial, near and distance visual acuities, the manifest refraction spherical equivalent, and patient satisfaction were evaluated in presbyopic eyes that had phacoemulsification cataract removal and implantation of a Crystalens AT-45 IOL accommodating IOL. The difference between preoperative and postoperative mean values was compared using the Student t and paired-sample t tests. Comparison between postoperative follow-up visits was by analysis of variance. RESULTS: The study comprised 25 eyes (23 patients; 13 men). The mean IOL power was 21.80 diopters (D) +/- 1.45 (SD) (range 19.00 to 24.00 D). At 6 months, 23 eyes (92%) had an uncorrected distance visual acuity (UDVA) of 6/12 or better; all eyes had a corrected distance visual acuity (CDVA) of 6/12 or better (P = .000). The difference in CDVA and UDVA between 1 month and 6 months postoperatively was not statistically significant. The mean distance-corrected near visual acuity (DCNVA) was J5 at 1 month and 6 months; from 1 month on, the DCNVA was J3 or better in more than 60% of eyes. There was a statistically significant difference in DCNVA between preoperatively and 6 months postoperatively (P = .021). CONCLUSIONS: Initial experience indicates that the accommodating IOL provides functional near and distance visual acuity for daily tasks. Surgeon experience and refinement of IOL calculations are required to improve outcomes.