Accommodative intraocular lenses: where are we and where we are going

Presbyopia still remains the last frontier of refractive surgery. Its surgical management is under constant evolution due to the limitations that exist today with respect to its management, which is probably in relation with the multifactorial basis in which presbyopia is clinically developed in the...

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Autores principales: Alió, Jorge L., Alió del Barrio, Jorge L., Vega-Estrada, Alfredo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5485553/
https://www.ncbi.nlm.nih.gov/pubmed/28674696
http://dx.doi.org/10.1186/s40662-017-0077-7
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author Alió, Jorge L.
Alió del Barrio, Jorge L.
Vega-Estrada, Alfredo
author_facet Alió, Jorge L.
Alió del Barrio, Jorge L.
Vega-Estrada, Alfredo
author_sort Alió, Jorge L.
collection PubMed
description Presbyopia still remains the last frontier of refractive surgery. Its surgical management is under constant evolution due to the limitations that exist today with respect to its management, which is probably in relation with the multifactorial basis in which presbyopia is clinically developed in the human. Until currently, virtually all surgical techniques that have been proposed for its correction are based on the induction of pseudoaccommodation in the presbyopic eye, including multifocality. However, the real restoration of accommodation is more complex, and it has been tried by the use of different, so called, “accommodative” pseudophakic intraocular lenses (AIOL). Overall, the reported results with these lenses by independent authors have been modest in relation with the restoration of the accommodative power of the eye and these modest benefits are usually lost with time due to the long term changes in the capsular bag. This fact made these lenses to be almost abandoned in the last few years, but there are currently other AIOL models being used with innovative mechanisms of action and different anatomical support outside the capsular bag that offer encouraging preliminary results that could bring a new potential of application to these types of lenses. In this article, we will update the modern refractive surgeon about the fundamentals and provide updated information about the outcomes of AIOLs by reviewing the concept of accommodation, the different attempts that have been accomplished in the past, their demonstrated published results in human clinical trials, and the future alternatives that may arrive in the near future.
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spelling pubmed-54855532017-07-03 Accommodative intraocular lenses: where are we and where we are going Alió, Jorge L. Alió del Barrio, Jorge L. Vega-Estrada, Alfredo Eye Vis (Lond) Review Presbyopia still remains the last frontier of refractive surgery. Its surgical management is under constant evolution due to the limitations that exist today with respect to its management, which is probably in relation with the multifactorial basis in which presbyopia is clinically developed in the human. Until currently, virtually all surgical techniques that have been proposed for its correction are based on the induction of pseudoaccommodation in the presbyopic eye, including multifocality. However, the real restoration of accommodation is more complex, and it has been tried by the use of different, so called, “accommodative” pseudophakic intraocular lenses (AIOL). Overall, the reported results with these lenses by independent authors have been modest in relation with the restoration of the accommodative power of the eye and these modest benefits are usually lost with time due to the long term changes in the capsular bag. This fact made these lenses to be almost abandoned in the last few years, but there are currently other AIOL models being used with innovative mechanisms of action and different anatomical support outside the capsular bag that offer encouraging preliminary results that could bring a new potential of application to these types of lenses. In this article, we will update the modern refractive surgeon about the fundamentals and provide updated information about the outcomes of AIOLs by reviewing the concept of accommodation, the different attempts that have been accomplished in the past, their demonstrated published results in human clinical trials, and the future alternatives that may arrive in the near future. BioMed Central 2017-06-26 /pmc/articles/PMC5485553/ /pubmed/28674696 http://dx.doi.org/10.1186/s40662-017-0077-7 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Review
Alió, Jorge L.
Alió del Barrio, Jorge L.
Vega-Estrada, Alfredo
Accommodative intraocular lenses: where are we and where we are going
title Accommodative intraocular lenses: where are we and where we are going
title_full Accommodative intraocular lenses: where are we and where we are going
title_fullStr Accommodative intraocular lenses: where are we and where we are going
title_full_unstemmed Accommodative intraocular lenses: where are we and where we are going
title_short Accommodative intraocular lenses: where are we and where we are going
title_sort accommodative intraocular lenses: where are we and where we are going
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5485553/
https://www.ncbi.nlm.nih.gov/pubmed/28674696
http://dx.doi.org/10.1186/s40662-017-0077-7
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