A New Approach to Motion That Might Cause Commotion
Might we have hit on the right method to achieve true accommodation?
Paul Beer |
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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