Long-term visual outcomes after Crystalens (R) HD intraocular lens implantation

Purpose: Our purpose was to evaluate the long-term visual outcomes after bilateral implantation of Crystalens (R) HD (Bausch and Lomb, Inc.) accommodative intraocular lenses. Methods: In this study, 25 patients (50 eyes) who underwent cataract surgery and bilateral Crystalens HD accommodative intraocular lens implantation were included. The Crystalens HD lens was implanted in the bag in both eyes, without any intra-or postoperative complications. The visual parameters measured before and after surgery were: uncorrected distance visual acuity, corrected distance visual acuity (CDVA) (using the Early Diabetic Retinopathy Study [EDTRS] logMAR charts), uncorrected intermediate visual acuity, and uncorrected near visual acuity using a Birkhauser reading chart, at a distance of 66 cm and 33 cm for intermediate and near vision, respectively, directly illuminated by a lamp of 60 watts. After surgery, the patients were evaluated at 1, 3, 6, 12, 24, and 36 months. Results: The mean age was 68.70 +/- 7.1 (range: 54 to 83) years. The mean follow-up was 42.72 +/- 0.49 (range: 42.33 to 43.27) months. The uncorrected distance visual acuity improved from 0.56 +/- 0.41 (range: 0 to 2) preoperatively to 0.19 +/- 0.13 (range: 0 to 0.38) (logMAR scale) at the last follow-up visit, and the CDVA improved from 0.17 +/- 0.18 (range: 0 to 0.7) preoperatively to 0.05 +/- 0.05 (range: -0.02 to 0.22) at the last follow-up visit. No eyes lost lines of CDVA during the follow-up period, while 54% of patients gained one or more lines of CDVA. The uncorrected intermediate and near visual acuity was J2 or better in 71% and 69% of our patients, respectively. Conclusion: Crystalens HD implantation seems to provide an improvement in visual acuity for far, intermediate, and near distances.