Factors which Influence Accommodative Amplitude in Crystalens HD Patients

Uday Devgan, MD, FACSDevgan Eye Surgery, Los Angeles, CA

FINANCIAL DISCLOSURES: Abbott Medical Optics: consultant, research, stockholder; Accutome Inc: speaker; Alcon Laboratories: stockholder ; Allergan: consultant, speaker, research funding, stockholder; Bausch & Lomb: consultant,

research funding; Calhoun Vision: research funding; Gerson Lehman Group: consultant; Inspire Pharma: stockholder; Ista Pharma: consultant, speaker, stockholder; iTherapeutix: research funding, travel support; Optos Inc: speaker, consultant; Pfizer

Inc: speaker, stockholder; Sirion Therapeutics: consultant; Specialty Surgical: stockholder; Staar Surgical: consultant (former), speaker, stockholder; Zeiss: speaker

Who are the best Who are the best Crystalens HD Crystalens HD

patients and why?patients and why?

Study DesignStudy Design

Retrospective analysis of 80 patientsRetrospective analysis of 80 patientsSingle surgeon (UD)Single surgeon (UD)Examination of the distance vision eye onlyExamination of the distance vision eye only

To avoid benefit of mono-vision / mini-monoTo avoid benefit of mono-vision / mini-monoNear vision measured through best-corrected Near vision measured through best-corrected

distance visiondistance vision

EvaluationEvaluationPatient Age:Patient Age: <65<65 65+65+

Prior LASIK:Prior LASIK: yesyes nono

Axial length:Axial length: <26<26mmmm >>2626mmmm

Capsulorrhexis:Capsulorrhexis: <5.5mm<5.5mm >>5.5mm5.5mm

IOL Orientation:IOL Orientation: verticalvertical horizontalhorizontal

AGE: Younger or OlderAGE: Younger or Older

Not statistically significant (P Not statistically significant (P >> 0.10) 0.10)

N=36 BDCNVA=J3.5

Age < 65 years Age > 65 years

N=44 BDCNVA=J4.1

Prior LASIK, PRK, RKPrior LASIK, PRK, RK

Not statistically significant (P Not statistically significant (P << 0.10) 0.10)

N=28 BDCNVA=J2.9

Prior Refractive Sx Virgin eye

N=52 BDCNVA=J3.7

Axial LengthAxial Length

Not statistically significant (P Not statistically significant (P << 0.10) 0.10)

N=68 BDCNVA=J3.7

Normal (<26mm) High Myope (>26mm)Or previous myope s/p LASIK

N=12 BDCNVA=J2.8

Capsulorrhexis SizeCapsulorrhexis Size

No dataNo data

N=1 Ant Cap YAG done

< 5.5 mm > 5.5 mm

N=79

IOL OrientationIOL Orientation

Not statistically significant (P Not statistically significant (P >> 0.10) 0.10)

N=47 BDCNVA=J3.6

Vertical Horizontal

N=33 BDCNVA=J3.7

Problems with my StudyProblems with my StudyPatients fell into multiple categories:Patients fell into multiple categories:

Prior LASIK more common in younger patientsPrior LASIK more common in younger patientsLong Axial Length more common in younger Long Axial Length more common in younger

patients and prior LASIK patientspatients and prior LASIK patientsNot enough patientsNot enough patientsPost-op timing of results should have been Post-op timing of results should have been

consistentconsistentNeed longer follow-up in post-op periodNeed longer follow-up in post-op periodNear vision not always measured at 16 inchesNear vision not always measured at 16 inches

Conclusions:Conclusions:

No statistically significant answersNo statistically significant answersSuggestions (Not Proven)Suggestions (Not Proven)::

Prior LASIK patients may do better perhaps Prior LASIK patients may do better perhaps due to other ocular aberrationsdue to other ocular aberrations

Patients with an Axial length > 26 mm may do Patients with an Axial length > 26 mm may do better due perhaps due to thin IOL, optics.better due perhaps due to thin IOL, optics.

Needs further analysisNeeds further analysis