Real-Time Imaging of Accommodation With Transscleral and Anterior Segment Optical Coherence Tomography
Purpose
To assess in real-time the accommodative response of the lens and the ciliary muscle with 2 combined Optical Coherence Tomography (OCT) systems on phakic and pseudophakic patients.
Methods
Prospective study performed at the Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL on presbyopic and non presbyopic patients as well as on patients with accommodative intraocular lens (IOL) and monofocal IOL. Transscleral OCT (wavelength = 1325nm) and combined high resolution spectral domain OCT (wavelength =840 nm) were performed in a non-accommodated state and during naturally induced accommodation using a custom made unit that provides accommodation/disaccommodation stimuli. Measurement of dynamic accommodative response of the lens, shift of the intraocular lens and anatomic change of ciliary muscle were evaluated.
Results
Mean axial shift of accommodative IOL was 42µm for 4D of accommodation. No ciliary muscle movements were recorded in the accommodative and monofocal IOL groups. Maximal thickness of the ciliary muscle in a non presbyopic patient was 0.58mm for 4 D of accommodation and 0.42mm in an unaccommodated state. Maximal thickness of the ciliary muscle in a presbyopic patient was 0.64mm for 4D of accommodation and 0.60 in an unaccommodated state.
Conclusion
The combined transscleral and high resolution anterior segment OCT system enabled to image simultaneously the dynamic response of the lens and the ciliary muscle during naturally induced accommodation.