Problem: To date, approaches to restore accommodation following cataract surgery have been based on the principle of a liquid or solid implant that moves within the capsular bag and thereby changes the optical characteristics of the eye. However, these implants have been associated with shrinking and fibrosis of the capsular bag, a problem that will not be solved in the foreseeable future.
Approach: If accommodation is effected by shifting the whole capsule including its contents on the optical axis, capsular fibrosis will virtually no longer play a role. In order to execute this shift via the neuronal feedback mechanisms of the ciliary muscle in a controlled way, radial zonular forces or movements must be transformed into axial ones, which is possible by means of tiny permanent magnets. This paper describes the basic aspects of such an implant. The dependence of accommodation on all relevant parameters is quantified in a computer simulation.
Conclusion: The implant described appears to be practicable with justifiable technical and surgical efforts.