[Evaluation of the valence objective and subjective methods for measuring pseudophakic accommodation]. 2013

D Uthoff, and W Haigis, and D Hepper, and M Pölzl, and D Holland
Augenklinik Bellevue, Lindenallee 21, 24105 Kiel. d.uthoff@augenklinik-bellevue.de

OBJECTIVE The aim of this study was to compare the validity and plausibility of various subjective and objective measurement methods for evaluation of pseudophakic accommodation. METHODS Eye Clinic Bellevue, Kiel, Germany. METHODS A total of 21 patients were examined over an average period of 34 months (range 12-51 months) after implantation of a potentially accommodative, model 1CU intraocular lens (IOL, HumanOptics, Germany). The following subjective measurements were taken: near point measurement with the accommodometer (Clement Clarke, Harlow, UK), defocus curve and near visual acuity with far and near reading charts. The IOLMaster (Carl Zeiss Meditec, Germany), ACMaster (Carl Zeiss Meditec, Germany) and Shin-Nippon K 5001 AR (Shin-Nippon, Japan) were employed as objective measurement devices. With this devices information is obtained about the anterior chamber depth (ACD, preoperative and postoperative), the movement of the IOL and the refractive change of eyes during the accommodative process. RESULTS Depending on the method utilized there were large variations of the examined IOL in relation to the extent of the measured accommodative effects in their entirety with the objective as well as the subjective measurement method. CONCLUSIONS A differentiation of pseudophakic accommodation and pseudophakic pseudoaccommodation is not possible with the conventional measurement methods applied and examined in this study. Only the ACMaster is an objective method for measurement of the axial shift of an IOL. However, subjective measurement methods can only record the total of both accommodation portions but do not allow any scientifically-founded statement about the functional principle of a potentially accommodative IOL.

UI MeSH Term Description Entries
D007910 Lenses, Intraocular Artificial implanted lenses. Implantable Contact Lens,Lens, Intraocular,Contact Lens, Implantable,Intraocular Lens,Intraocular Lenses,Lens, Implantable Contact
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000065 Accommodation, Ocular The dioptric adjustment of the EYE (to attain maximal sharpness of retinal imagery for an object of regard) referring to the ability, to the mechanism, or to the process. Ocular accommodation is the effecting of refractive changes by changes in the shape of the CRYSTALLINE LENS. Loosely, it refers to ocular adjustments for VISION, OCULAR at various distances. (Cline et al., Dictionary of Visual Science, 4th ed) Accommodation, Lens,Ocular Accommodation,Ocular Distance Accommodation,Accommodation, Ocular Distance,Distance Accommodation, Ocular,Lens Accommodation,Ocular Distance Accommodations
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D000369 Aged, 80 and over Persons 80 years of age and older. Oldest Old
D012680 Sensitivity and Specificity Binary classification measures to assess test results. Sensitivity or recall rate is the proportion of true positives. Specificity is the probability of correctly determining the absence of a condition. (From Last, Dictionary of Epidemiology, 2d ed) Specificity,Sensitivity,Specificity and Sensitivity
D014787 Vision Tests A series of tests used to assess various functions of the eyes. Test, Vision,Tests, Vision,Vision Test

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