The Predictability of Preoperative Pilocarpine-Induced Lens Shift on the Outcomes of Accommodating Intraocular Lenses Implanted in Senile Cataract Patients

Purpose. To evaluate the predictability of lens shift induced by pilocarpine (LS(Pilo)) on the outcomes of accommodating intraocular lens (Acc-IOL) implantation. Methods. Twenty-four eyes of 24 senile cataract patients who underwent phacoemulsification and Acc-IOL implantation were enrolled. LS(Pilo) was evaluated with anterior segment optical coherence tomography (AS-OCT). At 3 months postoperatively, the best corrected distance visual acuities (BCDVA), distance-corrected near visual acuities (DCNVA), and subjective and objective accommodations were measured. IOL shifts under accommodation stimulus (IOLS(Acc)) were evaluated with AS-OCT. Results. The mean LS(Pilo) was 112.29 ± 30.72 µm. LS(Pilo) was not associated with any preoperative parameters. The mean IOLS(Acc) was 130.46 ± 42.71 µm. The mean subjective and objective accommodation were 1.54 ± 0.39 D and 1.27 ± 0.41 D, respectively. The mean postoperative BCDVA and DCNVA (log MAR value) were 0.22 ± 0.11 and 0.24 ± 0.12, respectively. LS(Pilo) positively correlated with IOLS(Acc) (r = 0.541; P = 0.006), subjective accommodation (r = 0.412; P = 0.022), and objective accommodation (r = 0.466; P = 0.045), respectively. Conclusion. LS(Pilo) is an independent preoperative parameter associated with the postoperative Acc-IOL mobility and pseudophakic accommodation. It may offer valuable information for ophthalmologists in determining the suitable candidates for Acc-IOL implantation.