Comparison Of Accommodation Amplitude After Different Monofocal Posterior Chamber Intraocular Lens Implantation

Objective:To compare between the accommodation amplitude after the implantation of different types of posterior chamber monofocal intraocular lens and to analyze the associated influencing factors.Methods:A prospective clinical study comprised102eyes of102patients who underwent phacoemulsification and intraocular lens implantation in our hospital from August2010to August2011. The mean age was (72.39±6.50) years (range,57-84years old). Patients were divided into three groups according to the type of IOLs that implanted:Group Ⅰ,30patients (30eyes), were implanted with Rayner Superflex920H (Rayner) IOL; Group Ⅱ,41patients (41eyes), were implanted with AcrysoflQ SN60WF IOL (Alcon); Group Ⅲ,31patients, were implanted with Acrysof NATURAL SN60AT IOL (Alcon). The mean power of the implanted IOLs was (20.71±1.94) D. At6months postoperatively, uncorrected visual acuity, best corrected visual acuity, distance corrected near visual acuity were evaluated and recorded as the logarithm of minimum angle of resolution (logMAR). LENSTAR-900was used to measure the pupil size, axial length and anterior chamber depth; spherical aberration was measured by Hartmann-Shack wavefront sensor. Patients’subjective amplitude of accommodation was measured by integrated refractometer adjustment feet; while the objective amplitude of accommodation was measured by WR-5100automatic computer Refractometer (GrandSeiko). Statistical analysis of count data and measurement data were done separately by the chi-square test and variance analysis. Pearson correlation was performed to analyze the association between parameters.Results:The subjective amplitude of accommodation in group Ⅰ,Ⅱ,Ⅲ were (2.00±0.58) D,(2.26±0.60) D,(2.29±0.48) D, respectively, while the objective amplitude of accommodation in group Ⅰ,Ⅱ,Ⅲ were (0.87±0.37) D,(1.01±0.38) D,(1.04±0.37) D, respectively. There was no statistically significant difference between the subjective and objective amplitude of accommodation in the three groups (P=0.075, P=0.151). When the pupil diameter was3mm, the spherical aberrations of the three groups were (0.08±0.04) μm,(0.05±0.04) μm,(0.14±0.05)μm, respectively. The difference of spherical aberration between the three groups was statistically significant (P=0.000). There were no statistically significant differences between the three groups in age, power of the IOLs, uncorrected visual acuity, best corrected visual acuity,distance corrected near visual acuity, pupil size, axial length, anterior chamber depth (P>0.05totally). Age, axial length, pupil size were negatively related to the subjective and objective amplitude of accommodation; while the power of the IOLs was positively related to the subjective and objective amplitude of accommodation. No correlation was found in the anterior chamber depth as well as the spherical aberration with subjective or objective amplitude of accommodation (P>0.05totally)Conclusion:Compared with the implantation of Acrysof SN60AT spherical intraocular lens, the implantation of the Acrysof SN60WF aspherical intraocular lens and Rayner Superflex920H aspherical intraocular lens do not affect the amplitude of accommodation significantly. Age, axial length, pupil size are negatively related to the subjective and objective amplitude of accommodation; power of the IOLs is positively related to the subjective and objective amplitude of accommodation. Anterior chamber depth is not correlated with the subjective or objective amplitude of accommodation. No correlation is found between spherical aberration and subjective or objective amplitude of accommodation.