New Intraocular Lens Technology - 18/08/11

Doi : 10.1016/j.ajo.2005.03.061

Randall J. Olson, MD ^a,^⁎ , Liliana Werner, MD, PhD ^a, Nick Mamalis, MD ^a, Robert Cionni, MD ^b
^a Department of Ophthalmology and Visual Sciences, University of Utah, Salt Lake City, Utah
^b Cincinnati Eye Associates, Cincinnati, Ohio

Inquiries to Randall J. Olson, MD, Department of Ophthalmology and Visual Sciences, University of Utah, 50 North Medical Drive, Salt Lake City, Utah 84132; fax: 801-581-3357

Résumé

Purpose

To review the current status of phakic intraocular lenses (IOLs), intraocular treatment of presbyopia, and IOLs that filter some blue light.

Design

Review of current information on the subject from numerous sources.

Methods

Medline search and Internet search engines on the topics of phakic IOLs, presbyopia or multifocal IOLs, and blue light and macular degeneration.

Results

An iris fixated phakic IOLs is now approved in the United States (US). There are concerns for corneal endothelial stability and late dislocation. Other approaches include anterior chamber fixation with concerns of corneal endothelial stability and pupil elongation, and posterior chamber fixation with concerns of cataract formation, IOL dislocation, and pigment dispersion. Intraocular treatment of presbyopia includes monovision, multifocal, and accommodative IOLs. Which approach is superior today is still not clear. There are IOLs designed to block some blue light to potentially lessen the risk of age-related macular degeneration (ARMD). While there is presumptive evidence of this, no definitive study shows such a correlation. Color perception issues are unlikely to be a problem. While decreased scotopic vision has been proposed, there is no study that proves this is an issue of clinical significance.

Conclusions

The IOL field is dynamic with many new choices. Phakic IOLs and treatment of presbyopia will be an increasingly important part of ophthalmology; however, there are important unresolved issues. With better evidence that blue light is an important variable in ARMD, such an approach could rapidly become the standard.

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Plan

Results and discussion

Phakic IOLs

Intraocular surgery for presbyopia

IOLs that filter visible blue light

Conclusions

Supported in part by a grant from Research to Prevent Blindness, Inc, New York, New York, to the Department of Ophthalmology and Visual Sciences, University of Utah.
The authors acknowledge that no conflicting commercial interest or relationship exists between themselves or any other proprietary entity mentioned in or pertaining to the subject matter, with exception to Randall Olson who is a consultant for Advanced Medical Optics, and Robert Cionni who is a consultant for Alcon.