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Journal of Ophthalmology
Volume 2011 (2011), Article ID 284961, 8 pages
Review Article

Real and Pseudoaccommodation in Accommodative Lenses

Institute of Vision and Optics (IVO), University of Crete, Medical School, Heraklion, 71003 Crete, Greece

Received 7 March 2011; Revised 5 July 2011; Accepted 12 July 2011

Academic Editor: Rupert M. Menapace

Copyright © 2011 Ioannis G. Pallikaris et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


In the attempt to manage presbyopia, different intraocular lens designs have been proposed such as monofocal IOLs with monovision or multifocal IOLs. Even though the lenses mentioned offer satisfactory visual results, contemporary ophthalmology has not completely answered the presbyopic dilemma by simulating the accommodative properties of the crystalline lens itself. Accommodative IOLs were designed to fill this gap and provide satisfactory vision for all distances by restoring some degree of “pseudoaccommodation.” Pseudo accommodative capability can be linked to monofocal IOL’s as well but the results are not satisfactory enough to fully support unaided near vision. Pseudoaccommodation is a complex phenomenon that can be attributed to several static (i.e., pupil size, against-the-rule cylindrical refractive error, multifocality of the cornea) and dynamic (i.e., anterior movement of the implant itself) factors. Objective measurement of the accommodative capability offered by the accommodative IOLs is extremely difficult to obtain, and different methods such as autorefractometers, retinoscopy, and ultrasound imaging during accommodative effort, ray tracing, or pharmacological stimulation have been developed but the results are sometimes inconsistent. Despite the difficulties in measuring accommodation, accommodative IOLs represent the future in the attempt to successfully “cure” presbyopia.