DOI: 10.1177/11206721261462300 ISSN: 1120-6721

Accommodative changes after implantation of a foldable iris-fixated phakic intraocular lens for the correction of myopic astigmatism

Mariano Royo, Ángel Jiménez, Ainhoa Molina-Martin, David P Piñero
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Purpose

To analyze the amplitude of accommodation and its changes at a 6-month follow-up in healthy subjects implanted with an anterior chamber pIOL, assessing whether accommodative function is affected. Additionally, changes in visual performance and other ocular parameters were evaluated.

Methods

Prospective study including 57 subjects (age range, 18–45 years) implanted with the Artiflex pIOL (Ophtec) were evaluated at one week and six months postoperatively. Changes in manifest refraction, uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and other clinical variables were analyzed. Amplitude of accommodation (AA) was measured under photopic conditions using the Sheard method. One randomly selected eye per subject was included for analysis.

Results

Statistically significant reduction in refraction was observed (p < 0.001), remaining stable throughout follow-up visits. Accordingly, both the 1-week and 6-month visits demonstrated significant improvements in UDVA compared to baseline ( p  < 0.001). CDVA also improved significantly following IOL implantation ( p  < 0.001). Longitudinal analysis revealed no clinically or statistically significant changes in AA from baseline to 1-week ( p  = 0.096) or 6-month postoperative visits ( p  = 0.317) ( Table 2

). Mean change in AA in the whole sample was close to 0.10 ± 0.86 D. No significant differences were found in the accommodative changes found with spherical and toric models (p ≥ 0.092). Changes in AA at 1-week (ρ=0.378, p  = 0.004) and 6 months (ρ=0.336, p  = 0.011) were significantly correlated with age.

Conclusions

The implantation of Artiflex anterior chamber pIOL did not significantly affect the amplitude of accommodation in healthy subjects during the six-month follow-up period. Future comparative studies with posterior chamber pIOLs are needed.

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