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Business & Profession Cataract, Professional Development, Business and Innovation

A New Approach to Motion That Might Cause Commotion

At a Glance

  • Most cataract surgeons usually see an elastic capsular bag during a cataract procedure – retinal surgeons see a stiff, fibrosed bag months to years later
  • The fibrosed bag, sectioned appropriately, can actually help the right IOL vault forwards and backwards in response to ciliary muscle tension
  • Primate studies suggest that this approach results in IOL accommodation-disaccommodation similar to that of the crystalline lens
  • Getting an accommodative IOL right has the potential to be transformative, if only we can achieve true accommodation

When it comes to cataract surgery, I have a different perspective on the procedure: I’m a retinal surgeon. When I see an IOL in the capsular bag, it’s months or years after it was implanted and it’s no longer the elastic item cataract surgeons interact with. Instead, I usually see something that’s encased in a rigid and fibrosed disc. The lens is, effectively, straight-jacketed, so any chance of ciliary muscle-induced accommodation is long gone. I always thought that this was a shame – and the observation stuck with me. Might this be something that a simple solution could fix?

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About the Author

Paul Beer

Paul Beer is a Professor of Ophthalmology at Albany Medical Collage, has received multiple teaching awards, merit awards from the AAO, ASRS, and was appointed the principal investigator for 25 multicenter clinical trials and conducted multiple investigator-sponsored trials.

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