Pseudoaccommodation: BioComFold versus a foldable silicone intraocular lens

Purpose: To assess the degree of pseudoaccommodation amplitude correlated w ith shifts along the anteroposterior axis oi the BioComFold foldable intrao cular lens (IOL). Setting: Department of Ophthalmology, Hotel-Dieu Hospital, Paris, France. Methods: This prospective study comprised 30 eyes of 30 patients operated o n consecutively for cataract by phacoemulsification and in-the-bag implanta tion of a BioComFold (15 patients) or a foldable control (15 patients) IOL. The BioComFold IOL has a peripheral bulging ring that pushes the optic for ward during the effort to accommodate, creating a zoom effect. Pseudoaccomm odation amplitude was evaluated using the blurring of controlled vision by adding spheres, with the best correction for distance vision in place. Pupi l diameter was measured with a Goldmann campimeter under constant illuminat ion. Anterior chamber depth was determined by A-scan (Paxial, Biophysic Med ical) 30 minutes after cyclopentolate 1% was instilled and again 30 minutes after pilocarpine 2% was instilled. Results: The difference in pseudoaccommodation amplitude and pupil diameter between the 2 groups was not statistically significant (P = .6737 and P = .4014, respectively). The IOL's forward shifts from maximal ciliary relaxat ion to maximal ciliary contraction were significantly greater in the BioCom Fold group (P = .0215). Conclusion: The design of the BioComFold IOL allowed greater forward optic shifts along the anteroposterior axis during the effort to accommodate. Nev ertheless, this shift was not correlated with a significantly greater pseud oaccommodation amplitude.