Accommodating IOLs are based on the assumption that the cilary body cataract patients still functions and that the capsular bag has retained some elasticity.  In this scenario accommodation is lost primarily because of hardening of the natural crystalline lens which prevents its reshaping to generate a high refractive power curvature.  There are several accommodating IOLs under development, but the Crystalens by Eyeoincs is the first to receive FDA approval.  The Crystalens is a hinged haptic IOL that is designed to move forward when the patient accommodates.   The patient in this case had a Crystalens implanted in his left eye.  In a postoperative follow-up visit, he was reading J2.  However measurement on the iTrace system showed only about 0.5 D of overall accommodative change (green autorefraction numbers).  But under closer examination, one observes that centrally there are areas of more than 2.5 D of accommodative power.  This induced cylinder, possibly arising from arching of the lens, leads to pseudo accommodation that explains the patinet’s J2 reading result. 

Only the Tracey open field viewing technology allows the measurement of spatially resolved accommodation that is necessary to make this important determination of the mechanism of accommodation in this pseudophakic patient.