Accommodative Intraocular Lenses

Abstract

Presbyopia correction remains a considerable obstacle for ophthalmologists practicing today. There are several modes of treatment available, including formulations of topical medications, corneal excimer laser surgery, scleral devices, and intraocular lenses. The predominant course of action for pseudophakic presbyopia is the use of multifocal IOLs. The use of this treatment poses possible limitations for the patient, as this technology does not restore the accommodation itself and can induce a variety of photic phenomena. Accommodative IOLs (A-IOLs) were developed several years ago with the aim of counteracting disadvantages of multifocal IOLs and restoring real accommodation. That being said, since their inception A-IOLs have not been shown to be meaningfully effective in restoring real accommodation in a clinically significant manner in the long term. The primary reason for the failure of A-IOLs has been the relationship between secondary fibrosis and contraction of the capsular bag following lensectomy. Research continues on the improvement of this type of treatment and new advances in materials, technologies, and surgical approaches have borne new designs that may allow A-IOLs to overcome their obstacles. This chapter will delve into accommodation restoration in patients after cataract surgery. Specifically, it will provide an analysis of the different accommodative lenses that have been developed, their limitations, and new technologies on the horizon.