Correction of presbyopia: An integrated update for the practical surgeon

Balgos, Marie Joan Therese D; Vargas, Verónica; Alió, Jorge L.

doi:10.4103/tjo.tjo_53_18

Cited by 24 publications

(20 citation statements)

References 127 publications

(230 reference statements)

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“…An additional advantage of accommodative IOL technology is the potential to obviate the need for patients to experience the often-difficult period of neuroadaptation that is required with multifocal IOL. [ 11 36 ] Currently, only Crystalens has been the FDA approved for sale in the United States; a much larger variety of accommodative IOLs are available worldwide. Although promising, many new accommodative IOLs are still in development.…”

Section: Accommodative Intraocular Lensmentioning

confidence: 99%

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Intraocular lens correction of presbyopia

Sieburth¹,

Chen²

2019

Taiwan J Ophthalmol

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The continued development of intraocular lens (IOL) technology has led to a dramatic improvement in refractive outcomes. New and innovative ways of achieving the desired postoperative refractive goals continue to be developed. This article aims to review the currently available IOL modalities for correction of presbyopia at the time of cataract surgery, including reference to high-quality comparative studies, where available, and discussion of strengths as well as limitations of the currently available IOL technologies. It has been shown that multifocal compared to monofocal IOL was associated with higher rates of spectacle independence, but higher rates and severity of symptomatic glare as well as reduced contrast sensitivity. Within multifocal IOLs, diffractive compared to refractive IOLs tended to have better near vision and a lower rate of symptomatic glare. Extended depth-of-focus IOLs compared to diffractive multifocal IOL demonstrated equal or superior intermediate visual acuity, with less than or equal rates of glare. Accommodative IOLs represent a broad range of technologies that continue to develop, and new technologies offering opportunities for postoperative adjustment of refractive outcome are emerging.

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Section: Accommodative Intraocular Lensmentioning

confidence: 99%

“…In the case of Crystalens, the only FDA approved accommodative IOL available in the United States, the risk of capsular contraction syndrome (also known as Z syndrome) must be mitigated with use of central capsulorrhexis, adequate anterior capsular coverage of plate haptics, and fastidious cortex removal. [ 36 ]…”

Section: Surgical Planning Considerationsmentioning

confidence: 99%

Intraocular lens correction of presbyopia

Sieburth¹,

Chen²

2019

Taiwan J Ophthalmol

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“…Presbyopia is defined as the gradual inability to focus near objects on the retina due to insufficient accommodative ability following increasing age and the loss of elasticity in the crystalline lens. 1 , 2 , 3 A variety of factors are involved including hardening of the lens, changes in the elasticity of the lens capsule, lens dimension, geometry of zonular attachments and ciliary muscle contraction. However, it is still unknown how much each factor is responsible for this loss of accommodative ability.…”

Section: Introductionmentioning

confidence: 99%

Patients’ attitudes and beliefs to presbyopia and its correction

Hutchins

Huntjens

2021

Journal of Optometry

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Objective Presbyopia is the gradual inability to focus near objects with age. This study explores patients’ attitudes and beliefs towards presbyopia including preferred modes of near refractive correction. Methods In the United Kingdom, twenty-four volunteers completed an online questionnaire and attended a structured, recorded focus group. Participants’ age ranged between 36 and 48 years, representing a pre-presbyopic and a presbyopic population. Attitudes and beliefs about presbyopia, its significance, and opinions about current refractive correction including multifocal contact lenses were transcribed and coded using content analysis for overarching themes and patterns. Results Six participants (25%) were already wearing a near visual correction while 18 (75%) were not. Five key primary themes with clear inter-participant similarities were identified as ‘age-related’ (75%), ‘acceptance’ (50%), clear lack of ‘familiarity with the word presbyopia’ (65%), a mixed/ reluctant attitude ‘towards (multifocal) contact lenses’ (62.5%), and ‘comfort and convenience’ of a presbyopic correction (79%) whereby cost is of less importance. Conclusion The need for a reading correction was perceived as a sign of age. Spectacles were the most preferred mode of near vision correction, while comfort and convenience were seen as more important than cost. Patient education about presbyopia is lacking. Multifocal contact lenses are not necessarily the preferred visual correction even if the patient already wears contact lenses for distance.

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“…The procedure is minimally invasive and reversible. The main complications include decentration; biological intolerance, with corneal opacity; late hyperopic shift; and poor visual performance resulting from corneal irregularity [17]. In addition, some cases of explantation have been reported [18].…”

Section: Introductionmentioning

confidence: 99%

“…The emergence of a wide range of IOLs, including monofocal, extended depth-of-focus (EDOF), and multifocal with multifocal effects, make refractive lens exchange one of the most popular treatments for presbyopia [20]. Although multifocal IOLs increase spectacle independence and yield good visual results for near and distance vision, the main complications consist of an unpredictable neuroadaptation process, the presence of halos, and glare [17,21]. With a monofocal alternative, using correction for emmetropia in the dominant eye and a selected degree of myopia in the non-dominant eye, it is possible to have successful visual results, with less dysphotopsia symptoms than with multifocal IOLs, but at the cost of stereopsis and reduced contrast sensitivity [22].…”

Section: Introductionmentioning

confidence: 99%

Overview of pharmacological treatments for presbyopia

Orman¹,

Benozzi²

2021

Med Hypothesis Discov Innov Optom

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Background: Presbyopia is the normal progressive waning of accommodation with loss of the visual ability to focus on objects residing at different distances. Presbyopia exacts a cost in quality of life and professional efficiency of many people over 40 years of age. Presbyopia is likely to be 1 of the main pressing visual concerns of the 21st century, given that life expectancy is increasing, resulting in an aging population. This review aimed to address the 3 strategies of the pharmacological treatment for presbyopia. Methods: A review on PubMed/MEDLINE, Google Scholar, and Clinicaltrials.gov was performed to investigate the English literature on pharmacological treatment for presbyopia from beginning-of-year 2012 to September 30, 2020. Results: In addition to the treatment of presbyopia with glasses or contact lenses, new surgical strategies have been developed, some of which have been successful. However, during the last decade, a new, promising, non-invasive option for treating presbyopia has emerged: the pharmacological approach. Many researchers have developed 3 different lines of investigation from different assumptions, on a pharmacological basis. The first consisted of producing miosis, to take advantage of a pharmacologically induced pinhole effect, increasing depth-of-focus, and thus improving uncorrected near visual acuity. The second aimed to rehabilitate accommodation binocularly to enable good vision at all distances. Finally, the third approach attempted to rehabilitate lost elasticity in the human crystalline lens. Conclusions: None of the 3 discussed pharmacological strategies for treating presbyopia, prescribed globally, but patients of restoring accommodation strategy can adhere locally, where they are sold so far as master prescriptions.

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Correction of presbyopia: An integrated update for the practical surgeon

Cited by 24 publications

References 127 publications

Intraocular lens correction of presbyopia

Intraocular lens correction of presbyopia

Patients’ attitudes and beliefs to presbyopia and its correction

Overview of pharmacological treatments for presbyopia

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