Can cataract surgery cause ciliary muscle damage?

[ace399]

It seems common for Crystalens patients to not have close vision and minimal accommodation.  Can the IOL implant surgery cause damage to the ciliary muscle?

[Ray T Oyakawa, MD]

Unlikely,  the most common reason for poor near vision in a crystalens is missing target or residual astigmatism.  Since the eye can accommodate, a tech frequently over minuses the eye.  

Early on Eyeonics did not recommend implanting Crystalens in patients over 80.  I have a number of patient over 80 with Crystalens-the oldest being 89.  In general, their near is not as good as younger patients.  Most about j3 some j2, one patient J1

Dr. O.

[peakhope]

I would love to see statistics about how/if Crystalens near vision correlates with patient age. Even better would be "years since natural accommodation was lost". Do patients who are still accommodating, or who recently did so, more likely to be able to get strong accommodation with Crystalens? Or is there some other factor that determines whether or not near vision will work.

Of course, one clear contributing factor would be if the lens is actually put in at a nearsighted setting. Many doctors install a pair of Crystalens in a mini-monovision configuration, which obviously would increase near vision. Any statistics would need to account for that.

Statistics...I want statistics!

The numbers I remember (which I may have made up) is that Crystalens five-0 users mostly have between 1 and 2 diopters of accommodation, whereas HD users tend to have between 2 and 4.

Assuming a plano (0) target was hit, 1 diopter of accommodation would barely give you arms-length vision (1 meter), 2 diopters gets you to about 18 inches (half meter), and 4 would be closer than a foot (quarter meter).