Limits...
Current management of presbyopia.

Papadopoulos PA, Papadopoulos AP - Middle East Afr J Ophthalmol (2014 Jan-Mar)

Bottom Line: Presbyopia is a physiologic inevitability that causes gradual loss of accommodation during the fifth decade of life.Different approaches on the cornea, the crystalline lens and the sclera are being pursued to achieve surgical correction of this disability.The quality of vision, optical and visual distortions, regression of effect, complications such as corneal ectasia and haze, anisometropia after monovision correction, impaired distance vision and the invasive nature of the currently techniques have limited the utilization of presbyopia surgery.

View Article: PubMed Central - PubMed

Affiliation: Ophthalmology Clinic, Athens Metropolitan Hospital, Athens, Greece ; Ophthalmology Department, Slovak Medical University, Bratislava, Slovakia.

ABSTRACT
Presbyopia is a physiologic inevitability that causes gradual loss of accommodation during the fifth decade of life. The correction of presbyopia and the restoration of accommodation are considered the final frontier of refractive surgery. Different approaches on the cornea, the crystalline lens and the sclera are being pursued to achieve surgical correction of this disability. There are however, a number of limitations and considerations that have prevented widespread acceptance of surgical correction for presbyopia. The quality of vision, optical and visual distortions, regression of effect, complications such as corneal ectasia and haze, anisometropia after monovision correction, impaired distance vision and the invasive nature of the currently techniques have limited the utilization of presbyopia surgery. The purpose of this paper is to provide an update of current procedures available for presbyopia correction and their limitations.

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Flexivue Corneal Inlay, (photo courtesy of Prof. I. Pallikaris, University of Crete, Greece)
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Figure 1: Flexivue Corneal Inlay, (photo courtesy of Prof. I. Pallikaris, University of Crete, Greece)

Mentions: Refractive annular addition lenticules that work as bifocal optical inlays separating distance and near focal points (Flexivue Microlens, Presbia, Irvine, CA, USA). The Presbia Flexivue Microlens is made of a hydrophilic polymer, has a diameter of 3 mm and its edge thickness is approximately 15 μm57 [Figure 1]. The central 1.6 mm zone of the inlay is optically neutral. The Flexivue Microlens has a 0.5 mm hole in the center for allowing adequate nutritional flow in the cornea. Limnopoulou et al. reported uncorrected near visual acuity of 20/32 or better in 75% of operated eyes, whereas mean uncorrected distance visual acuity (UDVA) decreased statistically significantly from 0.06 logMAR (20/20) preoperatively to 0.38 logMAR (20/50) postoperatively.58 Mean binocular UDVA was not significantly altered.58 Overall, higher order aberrations increased and contrast sensitivity decreased in the operated eye.58 No tissue alterations were found using corneal confocal microscopy.58Figure 1


Current management of presbyopia.

Papadopoulos PA, Papadopoulos AP - Middle East Afr J Ophthalmol (2014 Jan-Mar)

Flexivue Corneal Inlay, (photo courtesy of Prof. I. Pallikaris, University of Crete, Greece)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3959035&req=5

Figure 1: Flexivue Corneal Inlay, (photo courtesy of Prof. I. Pallikaris, University of Crete, Greece)
Mentions: Refractive annular addition lenticules that work as bifocal optical inlays separating distance and near focal points (Flexivue Microlens, Presbia, Irvine, CA, USA). The Presbia Flexivue Microlens is made of a hydrophilic polymer, has a diameter of 3 mm and its edge thickness is approximately 15 μm57 [Figure 1]. The central 1.6 mm zone of the inlay is optically neutral. The Flexivue Microlens has a 0.5 mm hole in the center for allowing adequate nutritional flow in the cornea. Limnopoulou et al. reported uncorrected near visual acuity of 20/32 or better in 75% of operated eyes, whereas mean uncorrected distance visual acuity (UDVA) decreased statistically significantly from 0.06 logMAR (20/20) preoperatively to 0.38 logMAR (20/50) postoperatively.58 Mean binocular UDVA was not significantly altered.58 Overall, higher order aberrations increased and contrast sensitivity decreased in the operated eye.58 No tissue alterations were found using corneal confocal microscopy.58Figure 1

Bottom Line: Presbyopia is a physiologic inevitability that causes gradual loss of accommodation during the fifth decade of life.Different approaches on the cornea, the crystalline lens and the sclera are being pursued to achieve surgical correction of this disability.The quality of vision, optical and visual distortions, regression of effect, complications such as corneal ectasia and haze, anisometropia after monovision correction, impaired distance vision and the invasive nature of the currently techniques have limited the utilization of presbyopia surgery.

View Article: PubMed Central - PubMed

Affiliation: Ophthalmology Clinic, Athens Metropolitan Hospital, Athens, Greece ; Ophthalmology Department, Slovak Medical University, Bratislava, Slovakia.

ABSTRACT
Presbyopia is a physiologic inevitability that causes gradual loss of accommodation during the fifth decade of life. The correction of presbyopia and the restoration of accommodation are considered the final frontier of refractive surgery. Different approaches on the cornea, the crystalline lens and the sclera are being pursued to achieve surgical correction of this disability. There are however, a number of limitations and considerations that have prevented widespread acceptance of surgical correction for presbyopia. The quality of vision, optical and visual distortions, regression of effect, complications such as corneal ectasia and haze, anisometropia after monovision correction, impaired distance vision and the invasive nature of the currently techniques have limited the utilization of presbyopia surgery. The purpose of this paper is to provide an update of current procedures available for presbyopia correction and their limitations.

Show MeSH
Related in: MedlinePlus