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A drawback to most mechanical accommodating IOLs is that the ciliary muscle may not be strong enough to power the lens to provide an in-focus image at every distance.As a result, currently approved accommodating lenses typically can’t provide a full range of vision.(Toric designs correct astigmatism.) THE FAILED Synchrony (developed by Visiogen) was a mechanical accommodating IOL with two lenses that moved closer or farther apart to change focus.When Abbott Medical Optics (AMO) acquired Visogen for 0 million in 2009, Synchrony had just received CE marking in Europe.

A Review of the Current Pipeline THE APPROVED Crystalens® and Trulign® Toric (both by Bausch Lomb) are currently the only FDA-approved IOLs that can be described as accommodating.

In April 2011, Alcon was acquired by Swiss-based Novartis.

The company declined to invest in a subsequent round, and Elenza has claimed Novartis is attempting to “exploit the technologies invented by Elenza and to capture for itself 100 percent of the anticipated revenues from the commercialization of Elenza’s technologies.” The matter is in litigation.

THE PENDING Tetraflex (Lenstec) is a mechanical accommodating IOL with a single, square-edged, acrylic optic that flexes to provide accommodation. The Tek-Clear IOL (Tekia) is another square-edged, single-optic mechanical accommodating IOL that moves in response to natural movement of the ciliary muscle.

It received a CE mark in 2006, but is not yet FDA-approved.

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