Pseudoaccommodation: BioComFold versus a foldable silicone intraocular lens

Abstract

Purpose: To assess the degree of pseudoaccommodation amplitude correlated with shifts along the anteroposterior axis of the BioComFold foldable intraocular lens (IOL).

Setting: Department of Ophthalmology, Hôtel-Dieu Hospital, Paris, France.

Methods: This prospective study comprised 30 eyes of 30 patients operated on consecutively for cataract by phacoemulsification and in-the-bag implantation of a BioComFold (15 patients) or a foldable control (15 patients) IOL. The BioComFold IOL has a peripheral bulging ring that pushes the optic forward during the effort to accommodate, creating a zoom effect. Pseudoaccommodation amplitude was evaluated using the blurring of controlled vision by adding spheres, with the best correction for distance vision in place. Pupil diameter was measured with a Goldmann campimeter under constant illumination. Anterior chamber depth was determined by A-scan (Paxial, Biophysic Medical) 30 minutes after cyclopentolate 1% was instilled and again 30 minutes after pilocarpine 2% was instilled.

Results: The difference in pseudoaccommodation amplitude and pupil diameter between the 2 groups was not statistically significant (P = .6737 and P = .4014, respectively). The IOL's forward shifts from maximal ciliary relaxation to maximal ciliary contraction were significantly greater in the BioComFold group (P = .0215).

Conclusion: The design of the BioComFold IOL allowed greater forward optic shifts along the anteroposterior axis during the effort to accommodate. Nevertheless, this shift was not correlated with a significantly greater pseudoaccommodation amplitude.