Accommodating intraocular lenses for patients with cataract a review validating team fortress 2 file

A truly accommodative IOL (AIOL) would be the one capable of undergoing a progressive change in its power in relation with the active contraction of the ciliary body [1].Thus, the ideal AIOL would fully resolve the inconvenience of presbyopia and the side effects in relation with current surgical options as the positive visual symptoms or the deterioration of quality of vision after multifocal IOL implantation.According to Fincham’s findings where the curvature of an excised senile lens is considerably less than that from a juvenile one [12], the loss of accommodative power (presbyopia) is essentially due to the progressive failure of the capsule to mold the lens into a more spherical shape when the zonule is relaxed as a consequence of the progressive sclerosis and hardening of the lens substance with age.

This concept refers to any other method that changes the power of the whole optical system of the eye or changes partly the way in which it works in order to relieve patients for near distance vision.

The elasticity of the capsule is held in check by the normal tension in the zonule so that accommodation consists in the relaxation of the tension in the zonule by the contraction of the ciliary muscle.

This permits the capsule to mold the lens into a more strongly curved system (Table 1).

Current non-surgical treatment options include reading spectacles (either mono or varifocal) and contact lenses (either multifocal or monofocal for monovision), but many of these patients, spectacle independent previously, do not easily accept this unavoidable age-related life style change.

While corneal procedures for presbyopia are still under a serious debate regarding their long term outcomes and success rate, current surgical options mostly include refractive lens exchange by either monofocal IOLs for monovision or multifocal IOLs.

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However, none of them could achieve a complete restoration of accommodation, and multifocal lenses are frequently associated to visual symptoms that may decrease patient satisfaction.

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