Phaco-Ersatz: cataract surgery designed to preserve accommodation.

Phaco-Ersatz represents a new approach to cataract surgery and the correction of aphakia. The procedure involves the removal of the cataractous cortex and nucleus while preserving the lens capsule and its zonular attachments. The empty lens capsule is then refilled with biocompatible and optically suitable clear gel. A physiologic lens is recreated in situ. Experimental work with human cadaver eyes and rabbit and cat eyes in vivo demonstrates this surgical feasibility. A review of the literature reveals contradicting theories regarding the physical laws and lens properties governing accommodation. The accommodative potential of the ersatz lens has not been tested, but it may be speculated that this recreated lens may, in fact, possess some accommodative properties. Experimental investigations in this area represent the logical extension of intraocular lens implant development.