An investigation of the components of intraocular lens design that degrade the visual performance of accommodating and non-accommodating intraocular lenses due to their influence on lens epithelial cell growth following cataract surgery

[Truncated abstract] Good uncorrected distance visual acuity is no longer the singular aim of cataract surgery, as there is now demand to restore accommodation to the pseudophakic eye. Posterior capsule opacification (PCO) continues to compromise visual performance after cataract surgery and influence accommodative outcomes of new intraocular (IOL) designs. An effective accommodating IOL will produce actual changes in the optical power of the eye as a result of changes in IOL position and anterior chamber depth (ACD). These biometric changes must be measured objectively. Two open field autorefracting devices, the Tracey Visual Function Analyzer and the Shin-Nippon NVision-K 5001 agreed well with the gold standard of subjective refraction. The repeatability and reproducibility of the Shin-Nippon device was superior, therefore this device appeared to be more suited to accommodative measurements. Accommodative IOL movement was assessed with the Zeiss AC Master, utilising partial coherence interferometry (PCI), and the newer Zeiss Visante OCT. Anterior segment OCT underestimated ACD and overestimated accommodative IOL movement in comparison to the highly accurate PCI technique. Most accommodating IOLs utilise the focus shift principle, in which a single optic shifts forwards on flexible haptics with accommodative effort. Accommodative movement of these IOLs has been limited. A new IOL was evaluated in order to assess accommodative IOL shift as a function of haptic flexibility...