Measurement of accommodation with an open-field autorefractometer

Poster Details

First Author: G.Nemeth HUNGARY

Co Author(s):                  

Abstract Details

Purpose:

To assess objectively measurable, binocular amplitude of accommodation with a new device and comparing the results to subjective methods in phakic and in pseudophakic eyes implanted with monofocal intraocular lens.

Setting:

Department of Ophthalmology, Medical Health and Science Center, University of Debrecen, Hungary

Methods:

First, in 70 volunteers (44 with phakic eyes, age: 36.4±16.5 years and 26 bilateral pseudophakic patients, age: 69.3±9.9 years) we stimulated and measured accommodation by the subjective push-up method. Secondly, we measured the amplitude of accommodation and size of the pupil objectively with a binocular, open-field refractokeratometer (Grand Seiko WAM-5500). Finally, possible changes in anterior segment during accommodation process were obtained using built-in diopter scale of Pentacam HR.

Results:

In phakic eyes, subjective amplitude of accommodation was larger than the objective one (p<0.001). With 2.0 D of stimulus, the objective accommodation was 0.46±1.0 D, with 5.0 D stimulus, it was 2.2±2.01 D, while pupil diameter was 5.33±1.08 mm and 4.75±1.01 mm, respectively (p<0.01). The accommodative lag correlated with age (r=0.7; p<0.001). There are correlations between age and spherical aberration of the cornea (r=0.46; p<0.001), anterior chamber depth change during accommodation process (r=0.31; p<0.001) and pupil diameter in relaxed position (r= 0.568; p<0.001). Pupillary miosis was larger in older age (r=0.25; p=0.02). In pseudophakic eyes the (pseudo)accommodation amplitude only slightly correlated with age and spherical aberration (r=0.25; p<0.05).

Conclusions:

The Grand Seiko device is an easy-to-use way to measure accommodation amplitude and pupil objectively in phakic and pseudophakic eyes, in a bilateral way. The subjective method overestimates the objectively measurable, real accommodation amplitude. Corneal shape changes and pupillary miosis can help accommodation process in presbyopic and in pseudophakic eyes, too. FINANCIAL DISCLOSURE?: No