Potential Effect on the Retinoscopic Reflex of Scleral Expansion Surgery for Presbyopia

Hunter, Jennifer J.; Campbell, Melanie C. W.

doi:10.1097/01.opx.0000232813.73127.db

Cited by 8 publications

(3 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Rather than providing support for Schachar's theory, this reduction in circumlental space may, in fact, prevent the ageing eye from assuming its fully relaxed (or disaccommodated) shape. Further, although there is no in vivo evidence to support the concept of scleral expansion, Hunter and Campbell suggested that any subjective improvement in post-operative near vision might simply be due to an unintentional anterior displacement of the crystalline lens in combination with excess tilts and/ or decentrations (Hunter and Campbell, 2006), however, the concept and clinical acceptance of scleral expansion remains unsubstantiated.…”

Section: Surgical Approaches 631 Scleral Expansionmentioning

confidence: 99%

Presbyopia: Effectiveness of correction strategies

Wolffsohn

Davies

2019

Progress in Retinal and Eye Research

232

178

View full text Add to dashboard Cite

Presbyopia is a global problem affecting over a billion people worldwide. The prevalence of unmanaged presbyopia is as high as 50% of those over 50 years of age in developing world populations, due to a lack of awareness and accessibility to affordable treatment, and is even as high as 34% in developed countries. Definitions of presbyopia are inconsistent and varied, so we propose a redefinition that states "presbyopia occurs when the physiologically normal age-related reduction in the eye's focusing range reaches a point, when optimally corrected for distance vision, that the clarity of vision at near is insufficient to satisfy an individual's requirements". Strategies for correcting presbyopia include separate optical devices located in front of the visual system (reading glasses) or a change in the direction of gaze to view through optical zones of different optical powers (bifocal, trifocal or progressive addition spectacle lenses), monovision (with contact lenses, intraocular lenses, laser refractive surgery and corneal collagen shrinkage), simultaneous images (with contact lenses, intraocular lenses and corneal inlays), pinhole depth of focus expansion (with intraocular lenses, corneal inlays and pharmaceuticals), crystalline lens softening (with lasers or pharmaceuticals) or restored dynamics (with 'accommodating' intraocular lenses, scleral expansion techniques and ciliary muscle electrostimulation); these strategies may be applied differently to the two eyes to optimise the range of clear focus for an individual's task requirements and minimise adverse visual effects. However, none fully overcome presbyopia in all patients. While the restoration of natural accommodation or an equivalent remains elusive, guidance is given on presbyopic correction evaluation techniques.

show abstract

Section: Surgical Approaches 631 Scleral Expansionmentioning

confidence: 99%

Presbyopia: Effectiveness of correction strategies

Wolffsohn

Davies

2019

Progress in Retinal and Eye Research

232

178

View full text Add to dashboard Cite

show abstract

“…It has, for example, been suggested that the subjective improvement in near visual acuity achieved with scleral expansion procedures is a result of induced asymmetry or displacement of the crystalline lens [89]. Many of the currently used surgical techniques to restore accommodation rely on assumptions about the accommodative mechanism that are not supported by experimental evidence.…”

Section: Evaluation Of Surgical Procedures To Restore Accommodationmentioning

confidence: 99%

Cataract and Refractive Surgery

Kohnen¹,

Koch²

2009

Essentials in Ophthalmology

View full text Add to dashboard Cite

“…Surgery on the accommodative system, such as scleral implants, do not have the fundamental limitations described above, but have yet to show large and reproducible published effects, perhaps because their hypothesized mechanism of action plays a limited role in accommodation. 9 Similarly, accommodating IOLs provide an opportunity to restore the native accommodation of the eye without the limitations of multifocal approaches. For this reason, accommodating IOLs may be the ultimate solution for presbyopia after cataract surgery.…”

mentioning

confidence: 99%