Cataract surgery as the procedure to restore the quality of the optic system has reached an worldwide accepted high standard. The idea to restore accommodation during cataract surgery still is a dream. Detailed analysis of the mechanism of accommodation discloses the fact that despite the generally accepted serious of Helmholtz many parameters of the accommodation process are missing. It remains unclear how much ciliary muscle function is influenced during the general aging process as well as the growth of the natural lens interfears with a tension of the zonular fibres. Lens refilling procedures have been introduced in animal experiments over ten years ago but due to elect of sophisticated technology as well as the legging prove of principle whether to early results are transferable to humans we are still in a process of basic research.

Recent developments have focussed on the fact that an axial shift on the intraocular axis may course some refractive change of the optical system. Here the clinical effectiveness is not yet proven.

Animal experiments in primates seem to justify the further development of concepts based on lens refilling with materials of adequate refractive index and of mechanical behaviour similar to that in childhood.