Updated Crystalens HD Approved

On June 30, Bausch & Lomb announced that they had been given FDA approval to market Crystalens HDTM in the U.S. Crystalens is one of the intraocular lenses (IOLs) commonly used in a cataract surgery, or to treat presbyopia. There are two other IOLs used for these purposes, but they are multifocal, whereas Crystalens is accommodating.

What is Accommodation?

The eye's lens can change its shape, its curvature. When light enters the eye, the cornea bends it (refracts it), and it then passes through the lens, which refracts it again. In a 20/20 eye, this focuses the light clearly on the retina and all is well.

When the light entering the eye is coming from a distant object, it needs less refraction to focus on the retina. When it's coming from a nearby object, it needs more. Since the cornea cannot change its shape, the lens accommodates itself to the differing refraction needs. It becomes more convex for nearby objects and flatter for far objects. This happens automatically and we don't notice it as we glance from far to near.

If the lens is removed to treat cataracts or presbyopia, and replaced with an IOL, that accommodative ability is lost. The first IOLs were monofocal -- set for either distance or near vision. So you had to wear glasses for whichever distance the IOL did not correct.

How Crystalens Accommodates

A Crystalens IOL has a tiny hinge on each side and is attached to the eye's ciliary muscles which used to control the lens shape. Now they control the position of the Crystalens. They move it slightly forward to mimic increased curvature for near objects; and slightly back to mimic increased flatness for far objects.

Crystalens is the only FDA-approved accommodating IOL, and the Crystalens HD is its fourth generation. The surface has been reshaped so as to increase a person's depth of focus. In other words, it gives clearer near vision without reducing clarity for intermediate or far vision. It does this also without increasing any night vision problems like halos around light sources, or starbursts.

Bausch & Lomb began shipping Crystalens HD last week. Eye surgeons are instructed to use the same surgical protocols as they have previously used -- in other words, the procedure will be the same.

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