Anterior Segment Biometry of the Accommodating Intraocular Lens and its Relationship With the Amplitude of Accommodation

Objectives: To evaluate the anterior segment biometry of the Tetraflex accommodating intraocular lens (AIOL) and the contribution of forward movement to the amplitude of accommodation (AMP). Methods: Patients who underwent phacoemulsification with implantation of Tetraflex AIOLs and control nonaccommodating intraocular lenses were imaged by custom-built, long scan depth spectral-domain optical coherence tomography at relaxed and maximal accommodative states. Anterior segment biometry was performed and correlated with the clinical manifestation including AMP. Results: Patients in the Tetraflex group showed better distance-corrected near visual acuity (logMAR 0.43±0.10 vs. logMAR 0.51±0.10, P<0.05) and greater AMP (1.99±0.58 diopters [D] vs. 1.59±0.45 D, P<0.05) compared with the control group. The measurement of the postoperative anterior chamber depth (ACD) during accommodation showed a forward movement of the AIOLs in 16 eyes (69.6%). Compared with the control group, a greater proportion of cases in the Tetraflex group experienced forward movement (&khgr;2 test, P<0.001). The AMP in the AIOL group negatively correlated with changes in postoperative ACD during accommodation (r=−0.47, P<0.05), whereas AMP in the control group negatively correlated with postoperative pupil diameter (r=−0.57, P<0.05). Conclusions: The Tetraflex AIOLs seemed to have a tendency for forward movement; however, the slight forward axial shifts of the Tetraflex AIOL during natural accommodation may not produce a clinically relevant change in optical power.