Latest Trends for Corneal Correction of Presbyopia
Hala Mohamed AbdulWahab;
Abstract
Presbyopia is originally a Greek word which means “vision of the elderly”, it is a distressing chronic condition characterized by a slow insidious onset and a progressive course which seems to be a typical feature of senescence.
Presbyopia is a normal aspect of the aging process rather than a pathological condition and its peak prevalence is about 100% by the age of 50 years.
Understanding the etiology and mechanism of presbyopia depends greatly on understanding the mechanism of accommodation in the young eye. Helmholtz did a lot of work during the 19th century for understanding those mechanisms, suggesting that as the ciliary muscle contracts, the zonules become loose and the lens becomes rounder. While Schachar proposed a theory during the 20th century that claims that the zonules become tighter to distort the centre of the lens into a more steeply rounded shape. Eventually the presbyopia has no definitive pathophysiology, it is likely to result from deterioration in structure and function of a number of inter-related tissues including changes in crystalline lens dimensions with age, the associated change in geometry of zonular attachments, and changes in viscoelastic properties of the lens capsule and lens matrix.
Treatment options included optical compensation either with reading glasses or bifocal and progressive multifocal spectacles and contact lenses or by a number of surgical options.
The convential dependence on reading spectacles or contact lenses for correction of presbyopia may be unsuitable for the patient’s normal daily activities, spectacles can be hard to tolerate, represent a cosmetic issue or maybe inappropriate for certain activities, that’s why an increasing number of patients seek surgical correction.
The surgical treatment options for presbyopia include different approaches, some of them are outdated namely: scleral surgery by scleral expansion bands (SEB) or anterior ciliary sclerotomy (ACS), accommodative lens implants and laser modification of the crystalline lens. Another option is refractive lens exchange with using accomodative or multifocal (IOLs) before development of significant cataract which is considered too invasive in early stages of presbyopia.
Presbyopia is a normal aspect of the aging process rather than a pathological condition and its peak prevalence is about 100% by the age of 50 years.
Understanding the etiology and mechanism of presbyopia depends greatly on understanding the mechanism of accommodation in the young eye. Helmholtz did a lot of work during the 19th century for understanding those mechanisms, suggesting that as the ciliary muscle contracts, the zonules become loose and the lens becomes rounder. While Schachar proposed a theory during the 20th century that claims that the zonules become tighter to distort the centre of the lens into a more steeply rounded shape. Eventually the presbyopia has no definitive pathophysiology, it is likely to result from deterioration in structure and function of a number of inter-related tissues including changes in crystalline lens dimensions with age, the associated change in geometry of zonular attachments, and changes in viscoelastic properties of the lens capsule and lens matrix.
Treatment options included optical compensation either with reading glasses or bifocal and progressive multifocal spectacles and contact lenses or by a number of surgical options.
The convential dependence on reading spectacles or contact lenses for correction of presbyopia may be unsuitable for the patient’s normal daily activities, spectacles can be hard to tolerate, represent a cosmetic issue or maybe inappropriate for certain activities, that’s why an increasing number of patients seek surgical correction.
The surgical treatment options for presbyopia include different approaches, some of them are outdated namely: scleral surgery by scleral expansion bands (SEB) or anterior ciliary sclerotomy (ACS), accommodative lens implants and laser modification of the crystalline lens. Another option is refractive lens exchange with using accomodative or multifocal (IOLs) before development of significant cataract which is considered too invasive in early stages of presbyopia.
Other data
| Title | Latest Trends for Corneal Correction of Presbyopia | Other Titles | التقنيات الحديثة المعتمدة على القرنية لعلاج قصو البصر الشيخوخي | Authors | Hala Mohamed AbdulWahab | Issue Date | 2015 |
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