Anterior ciliary sclerotomy for treatment of presbyopia

Objective accommodation measurements in prepresbyopic eyes using an autorefractor and an aberrometer

“…3,5,[9][10][11][12] There has been considerable interest in prospects for surgically restoring active and dynamic accommodation to the presbyopic eye with scleral expansion procedures or intraocular lenses (IOLs) designed to move with an accommodative effort to create a true change in the optical power of the eye for objects at near distances. [13][14][15][16][17][18][19][20][21][22][23][24][25] Although subjective clinical assessments suggest high levels of patient satisfaction and good visual performance, 14,[24][25][26] objectively measured accommodative performance with these procedures have been disappointing. 16,[27][28][29] Subjective accommodation testing, such as the routinely used clinical push-up test, is inappropriate for unequivocally demonstrating an accommodative optical change in the power of the eye.…”

Update on bimanual microincisional cataract surgery

“…Scleral expansion restoration of accommodation is based on revisionist theories of accommodation [20,31,32] that are untenable [9], and has been shown to be ineffective [33][34][35][36][37]. Surgical manipulations of the sclera cannot reverse lens hardening or restore the accommodative capacity to the lens.…”

“…Studies using subjective tests such as distance-corrected near-visual acuity and dynamic retinoscopy, however, provide no evidence of whether active accommodation is present with the accommodative intraocular lenses. Only the use of objective measures can settle the debate over whether or not accommodation is restored with accommodation restoration procedures including scleral expansion [33][34][35][36][37] or accommodative intraocular lenses [78 • ,79,80].…”

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“…Many approaches in order to achieve a functional vision for all distances as if we had again 20 [19][20][21][22][23][24][25][26][27][28], Scleral Ciliary Surgery [29], corneal inlays [30][31][32], monovision [33,34] and accommodative intraocular lenses [35,36]. In this summary a description of the accommodative intraocular lenses (AIOLs) is presented.…”