A Study on Cases of Good Apparent Accommodation Using an All-distance Visual Acuity Chart and Corneal Shape Analysis

As a part of an attempt to elucidate the mechanism of apparent accommodation, an evaluation was made of patients with good apparent accommodation using an all-distance visual acuity chart and corneal shape analysis.The study was performed on 6 patients (7 eyes) in a good apparent accommodation group and 13 patients (15 eyes) in a poor apparent accommodation group. These were selected from patients who had undergone normal small-incision ultrasonic phacoemulsification and posterior chamber type single focus intraocular lens implantation. In these patients, all-distance visual acuity was measured using an AS-15(Kowa Co., Ltd.), and corneal shape analysis was performed using Orbscan (Orbtek Inc.).In all-distance visual acuity, gentle decline from far to near was noted in the poor apparent accommodation group, and the degree of decline was lower in the good apparent accommodation group. Also, a two-peak pattern, showing decline at first and then an increase, was observed in some of the cases. In corneal shape analysis, there was no specific pattern in the good apparent accommodation group. However, the difference between maximum refractive power and minimum refractive power of cornea in the ranges of 3, 5, and 7 mm in total optical power (TOP) was significantly higher in the good apparent accommodation group compared with the poor apparent accommodation group (TOP 3 mm: p = 0.0233, TOP 5 mm: p = 0.0306, TOP 7 mm: p = 0.0035).In the present study, there were three patterns in all-distance visual acuity in the good apparent accommodation group, showing a two-peak pattern, a flat pattern, and a gentle decline, and the pattern of gentle decline was observed more often than the other patterns. The results of the study also suggest that the gradient of corneal refractive power may be related to apparent accommodation.