A systematic review of the recent literature regarding pseudophakic monovision as a reliable methods for presbyopia correction was performed based on the PubMed, MEDLINE, Nature and the American Academy of Ophthalmolo...A systematic review of the recent literature regarding pseudophakic monovision as a reliable methods for presbyopia correction was performed based on the PubMed, MEDLINE, Nature and the American Academy of Ophthalmology databases in July 2015 and data from 18 descriptive and 12 comparative studies were included in this narrative review. Pseudophakic monosvision seems to be an effective method for presbyopia with high rates of spectacles independence and minimal dysphotopsia side- effects, that should be considered by the modern cataract surgeons.展开更多
AIM: To investigate the one-year refractive outcomes and optical quality following PRESBYOND laser-blended vision(LBV).METHODS: This retrospective study included 20 patients who underwent PRESBYOND treatment between J...AIM: To investigate the one-year refractive outcomes and optical quality following PRESBYOND laser-blended vision(LBV).METHODS: This retrospective study included 20 patients who underwent PRESBYOND treatment between Jan 2019 and Aug 2020. The patients were asked to attend a followup outpatient visit one year after surgery. Distance and near visual acuity as well as subjective refraction were examined. Optical quality was assessed using wavefront-supported custom ablation. A questionnaire evaluating optical quality and satisfaction was completed at the last visit.RESULTS: The average patient age was 48.1±7.4 y(range, 41 to 58 y). The mean preoperative spherical equivalent was-7.59±2.39D. At the one-year follow-up, two eyes(both dominant eyes) lost one line of corrected distance visual acuity(CDVA), while the remaining eyes(38/40) maintained or gained lines of CDVA. The average binocular uncorrected distance visual acuity improved from 0.15±0.03 to 0.90±0.26(decimal vision;P<0.001). The average binocular uncorrected near visual acuity increased from 0.34±0.28 to 0.97±0.07(P<0.001). The spherical aberration was 0.04±0.06 μm in the nondominant eye and 0.09±0.09 μm in the dominant eye(P=0.02). All patients were satisfied with or accepted the outcomes of the surgery. The primary complaints were related to disturbances in night vision and relatively inferior near vision.CONCLUSION: Over the one-year observation period, PRESBYOND is a safe and effective option for presbyopia correction. The optical quality and near vision deserve further investigation.展开更多
●AIM:To analyze one year clinical outcomes and subjective rating of hybrid bi-aspheric multifocal central presbyLASIK with micro-monovision for correction of presbyopia and myopic astigmatism.●METHODS:Seventy-four e...●AIM:To analyze one year clinical outcomes and subjective rating of hybrid bi-aspheric multifocal central presbyLASIK with micro-monovision for correction of presbyopia and myopic astigmatism.●METHODS:Seventy-four eyes of 37 patients consecutively treated with presbyLASIK were assessed.The mean age of the patients was 43.8±3.0 y with a mean spherical equivalent refraction of-5.21±1.87 diopters(D)and mean astigmatism of-0.82±0.64 D.Visual acuity,manifest refraction,contrast sensitivity,aberrometry and patients’subjective rating were evaluated pre-and postoperatively.●RESULTS:At 1 y postoperatively(68 eyes of 34 patients),the mean spherical equivalent(SE)refraction in distance eyes was 0.06±0.05 D,whereas the achieved SE in near eyes was-0.83±0.05 D.Ninety-nine percent of eyes were within±0.50 D of target correction of SE.The binocular mean uncorrected distance visual acuity(UDVA)was 0.00±0.18 logMAR(20/20).Sixty-four percent of patients achieved 0.0 logMAR(20/20)or better of UDVA and 0.1 logRAD or better of UNVA as well.There was a binocularly loss of one line CDVA after surgery for only one patient(3%,1/34)and no patient lost 2 lines.The changes in binocular contrast sensitivity(CS)in all test conditions were not significant at any frequency after surgery.The changes of entire eye total higher order aberrations(tHOA)and spherical aberrations(SA)significantly higher in near eyes than in distance eyes.The overall satisfaction score for surgery was 93±8.●CONCLUSION:The hybrid bi-aspheric multifocal central presby LASIK with micro-monovision appears to be an efficacious option for myopic presbyopes.One year postoperative outcomes in a relatively young presbyopia population indicate improvements in both far and near vision with high satisfaction.展开更多
AIM:To assess the clinical performance of a multifocal corneoscleral lens for the presbyopia correction.METHODS:A prospective clinical trial of the OnefitTM A multifocal corneoscleral lens was conducted with 40 partic...AIM:To assess the clinical performance of a multifocal corneoscleral lens for the presbyopia correction.METHODS:A prospective clinical trial of the OnefitTM A multifocal corneoscleral lens was conducted with 40 participants with presbyopia.At 4 wk of continuous wear of the corneoscleral lens,changes in the distance,intermediate,and near visual acuity(VA)were evaluated.The safety of the corneoscleral lens,central corneal thickness(CCT),corneal endothelial cell count,binocular stereopsis,tear film break-up time(BUT),corneal staining,corneal edema,corneal neovascularization(NV),and conjunctival hyperemia were examined.In addition,a subjective questionnaire addressing satisfaction(rated from 1 to 5 points)and discomfort(rated from 1 to 5 points)was administered.RESULTS:Forty participants were enrolled in this study.Six participants were excluded because of poor compliance with lens fitting(n=2)and loss to follow-up(n=4).The mean age of the participants was 53.0±4.9 y.At 4 wk of continuous wear of the corneoscleral lens,the best corrected far,intermediate,and near VA was 0.08±0.11,0.10±0.12,and 0.10±0.12 log MAR,respectively.These results were significant improvements over the baseline uncorrected VA(far:P=0.004;intermediate:P=0.004;near:P=0.002).CCT,corneal endothelial cell count,binocular stereopsis,BUT,corneal staining,corneal edema,corneal NV,and conjunctival hyperemia were not significantly different between baseline and after corneoscleral lens use.The average satisfaction scores for fit sensation;corrected far,intermediate,and near VA;and ease of handling were 4.1,3.4,3.6,3.5,and 3.4,respectively.The average discomfort scores for dryness,irritation,foreign body sensation,redness,fogging,and halo were 1.7,1.8,1.5,1.7,1.7,and 1.3,respectively.CONCLUSION:Far,intermediate,and near VA are improved in presbyopic patients with the multifocal corneoscleral lens compared to uncorrected baseline VA,without adverse ocular effects.This evidence supports the safety and effectiveness of presbyopia correction with multifocal corneoscleral lenses.展开更多
Background:Presbyopia,a common age-related condition affecting near vision,impacts over a billion people worldwide.The aim of this paper is to review the main reports and results of clinical trials,comparing the newes...Background:Presbyopia,a common age-related condition affecting near vision,impacts over a billion people worldwide.The aim of this paper is to review the main reports and results of clinical trials,comparing the newest pharmacological treatment options for presbyopia,their mechanisms of action,and possible side effects.Main text:Pharmacological approaches,involving eye drops that target the underlying mechanisms of presbyopia,have gained growing interest.Two key pharmacological agents in this field are miotics and lens softeners.Miotics enhance near vision temporarily by creating a pinhole effect,though they may cause side effects and are under further investigation for long-term use with ongoing research also exploring the potential benefits of combining them with other drugs to improve outcomes and reduce adverse reactions.Lens softeners,on the other hand,aim to restore the flexibility of the lens,addressing one of the primary causes of presbyopia.Despite early trials,further development of lens softeners has been suspended.A notable advancement in this field is the recent FDA approval of 1.25%and 0.4%pilocarpine,a miotic agent,for presbyopia treatment.This milestone highlights the growing interest in pharmacological solutions for presbyopia,with several new drugs and their combinations currently being investigated for potential FDA approval.Conclusions:pharmacological treatments,particularly miotics like pilocarpine,represent a promising alternative to conventional methods for managing presbyopia.Continued research into these treatments,especially combinations of drugs,may offer more effective and convenient options for presbyopia patients in the future.展开更多
Presbyopia corrections traditionally have been approached with attempts to exchange power,either at the cornea or the lens planes,inducing multifocality,or altering asphericity to impact the optical system.Treatments ...Presbyopia corrections traditionally have been approached with attempts to exchange power,either at the cornea or the lens planes,inducing multifocality,or altering asphericity to impact the optical system.Treatments that affect the visual axis,such as spectacle and contact lens correction,refractive surgeries,corneal onlays and inlays,and intraocular lenses are typically unable to restore true accommodation to the presbyopic eye.Their aim is instead to enhance‘pseudoaccommodation’by facilitating an extended depth-of-focus for which vision is sufficient.There is a true lack of technology that approaches presbyopia from a treatment based or therapy based solution,rather than a‘vision correction’solution that compromises other components of the optical system.Scleral surgical procedures seek to restore true accommodation combined with pseudoaccommodation and have several advantages over other more invasive options to treat presbyopia.While the theoretical justification of scleral surgical procedures remains controversial,there has nevertheless been increasing interest and evidence to support scleral surgical and therapeutic approaches to treat presbyopia.Enormous progress in scleral surgery techniques and understanding of the mechanisms of action have been achieved since the 1970s,and this remains an active area of research.In this article,we discuss the historic scleral surgical procedures,the two scleral procedures currently available,as well as an outlook of the future for the scleral surgical space for treating presbyopia.展开更多
Background:To test and compare in a masked fashion the efficacy of using a parasympathomimetic drug(3%carbachol)and an alpha-2 agonist(0.2%brimonidine)in both combined and separate forms to create optically beneficial...Background:To test and compare in a masked fashion the efficacy of using a parasympathomimetic drug(3%carbachol)and an alpha-2 agonist(0.2%brimonidine)in both combined and separate forms to create optically beneficial miosis to pharmacologically improve vision in presbyopia.Methods:A prospective,double-masked,randomized,controlled clinical trial was conducted.Ten naturally emmetropic and presbyopic subjects between 42 and 58 years old with uncorrected distance visual acuity of at least 20/20 in both eyes without additional ocular pathology were eligible for inclusion.All subjects received 3%carbachol and 0.2%brimonidine in both combined and separate forms,3%carbachol alone and 0.2%brimonidine(control)alone in their non-dominant eye in a crossover manner with one week washout between tests.The subjects’pupil sizes and both near and distance visual acuities will be evaluated pre-and post-treatment at 1,2,4,and 8 h,by a masked examiner at the same room illumination.Results:Statistically significant improvement in mean near visual acuity(NVA)was achieved in all subjects who received combined 3%carbachol and 0.2% brimonidine in the same formula compared with those who received separate forms or carbachol alone or brimonidine alone(P<0.0001).Conclusion:Based on the data,the combined solution demonstrated greater efficacy than the other solutions that were tested.Improving the depth of focus by making the pupil small caused statistically significant improvement in near visual acuity,with no change in binocular distance vision.Trial registration:ACTRN12616001565437.Registered 11 November 2016.展开更多
The main purpose of this review is to compare and analyze the results of the main PresbyLASIK approaches;central and peripheral.Summary:A comprehensive research was conducted in PUBMED using keywords like“presbyopia ...The main purpose of this review is to compare and analyze the results of the main PresbyLASIK approaches;central and peripheral.Summary:A comprehensive research was conducted in PUBMED using keywords like“presbyopia correction”,“PresbyLASIK”,“Corneal multifocality”,“Laser blended vision”.We reviewed the PresbyLASIK technique,uncorrected distance visual acuity(UDVA),corrected distance visual acuity(CDVA),uncorrected near visual acuity(UNVA),and corrected near visual acuity(CNVA),and compared the differences between the techniques.展开更多
Introduction:Presbyopia affects people from the 4^(th) decade of life and is characterized by accommodative loss that leads to negative effects on vision-targeted health-related quality of life.A non-invasive pharmaco...Introduction:Presbyopia affects people from the 4^(th) decade of life and is characterized by accommodative loss that leads to negative effects on vision-targeted health-related quality of life.A non-invasive pharmacological treatment providing near-lenses independence would be a truly groundbreaking approach in the treatment of presbyopia.The purpose of this review is to analyze the emerging pharmacological solutions proposed to address presbyopia.Results:Several ophthalmic eye drops compounds solutions have been described in peer-reviewed papers or presented in ophthalmological tabloids and congresses.Each topical treatment deals with drug combinations aimed to modify one or more factors involved in the accommodative process and have been proposed to be instilled either monocularly or binocularly.It remains unclear how much each drug in the final combined form is involved in the achievement of the outcome and contributes to it.Conclusion:Despite the lack of a completely well understood mechanism,pharmacological control of presbyopia seems to be a possible and very attractive alternative for presbyopic patients.The studies mentioned in this review are to be considered pilot investigations as they involve either a small number of subjects or are single case series.Complete studies are needed to confirm which will be the more effective pharmacological compound for the treatment of presbyopia.展开更多
Background:Presbyopia has become a global disease affecting the world's aging population.Among various treatments,cataract extraction and intraocular lens(IOL)implantation have become the most popular and common m...Background:Presbyopia has become a global disease affecting the world's aging population.Among various treatments,cataract extraction and intraocular lens(IOL)implantation have become the most popular and common methods of presbyopia correction.During the twentieth century,IOLs have underwent significant innovation and advancements to meet the patients'high demands for functional vision at all distances.Main Text:To meet the increasing needs for excellent near and intermediate vision for daily activities,some premium IOLs with more than one focus have been developed,for example,the refractive MfIOLs,diffractive MfIOLs,extended depth of field(EDOF)IOLs,and accommodating IOLs(AIOLs)were introduced to meet this need.In addition,the add-on MfIOLs have been explored as promising supplementary IOLs for pseudophakic presbyopia.When selecting the MfIOLs,the IOLs'features,patients’characteristics,preoperative eye conditions,and treatment expectations should be considered.Conclusions:In this review,we focus on the multifocal IOLs(MfIOLs)commonly used for presbyopia correction and systematically summarized their optical designs and clinical outcomes.More evidence-based studies are required to provide guidelines for MfIOL selection,provide maximum visual benefits,and develop personalized visual solutions in the future.展开更多
Background:The accommodation has considerable interactions with the pupil response,vergence response and binocularity.The transformation of visual reception processing and the changes of the binocular cooperation duri...Background:The accommodation has considerable interactions with the pupil response,vergence response and binocularity.The transformation of visual reception processing and the changes of the binocular cooperation during the presbyopia development are still poorly studied.So,the regularities of visual system violation in the presbyopia formation need to be characterized.This study aims to reveal the transformation of visual reception processing and to determine the role of disturbances in binocular interactions in presbyopia formation.Methods:This study included 60 people with emmetropic refraction,uncorrected distance visual acuity 1.0 or higher(decimal scale),normal color perception,without concomitant ophthalmopathology.The first group consisted of 30 people(from 18 to 27 years old)without presbyopia,the second cohort comprised 30 patients(from 45 to 55 years old)with presbyopia.The eyeball anatomy and optics were evaluated using ultrasound biomicroscopy,aberrometry,and pupillometry.The functional state of the visual system was investigated under monocular and binocular conditions.The registration of the disparate fusional reflex limits was performed by the original technic using a diploptic device which facilitated investigation of the binocular interaction under natural conditions without the accommodation response,but with the different vergence load.The disparate fusional reflex was analyzed using the proximal and distal fusion borders,and the convergence and divergence fusion borders.The calculation of the area of binocularity field was performed in cm2.Results:The presbyopia formation is characterized by a change in an intraocular anatomy,optics,visual processing,and binocularity.The processes of binocular interaction inhibition make a significant contribution to the misalignment of the visual perception.The modification of the proximal,distal and convergence fusion borders was determined.It was revealed that 87%of the presbyopic patients had binocularity shortage,whereas the reduction of binocularity field area in extreme grade was seen in 6%of cases.Conclusions:The presbyopia formation is accompanied by a significant reorganization of the visual system activity and by the creation of the new visual processing interactions.These data may be useful in presbyopia surgery.展开更多
文摘A systematic review of the recent literature regarding pseudophakic monovision as a reliable methods for presbyopia correction was performed based on the PubMed, MEDLINE, Nature and the American Academy of Ophthalmology databases in July 2015 and data from 18 descriptive and 12 comparative studies were included in this narrative review. Pseudophakic monosvision seems to be an effective method for presbyopia with high rates of spectacles independence and minimal dysphotopsia side- effects, that should be considered by the modern cataract surgeons.
基金Supported by National Natural Science Foundation of China(No.81770955)National Natural Science Foundation of China for Young Scholars(No.82000929)+6 种基金Project of Shanghai Science and Technology(No.20410710100)Clinical Research Plan of SHDC(No.SHDC2020CR1043B)Project of Shanghai Xuhui District Science and Technology(No.2020-015)Project of Shanghai Xuhui District Science and Technology(No.XHLHGG202104)Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care(No.20DZ2255000)Shanghai Sailing Program(No.20YF1405000)。
文摘AIM: To investigate the one-year refractive outcomes and optical quality following PRESBYOND laser-blended vision(LBV).METHODS: This retrospective study included 20 patients who underwent PRESBYOND treatment between Jan 2019 and Aug 2020. The patients were asked to attend a followup outpatient visit one year after surgery. Distance and near visual acuity as well as subjective refraction were examined. Optical quality was assessed using wavefront-supported custom ablation. A questionnaire evaluating optical quality and satisfaction was completed at the last visit.RESULTS: The average patient age was 48.1±7.4 y(range, 41 to 58 y). The mean preoperative spherical equivalent was-7.59±2.39D. At the one-year follow-up, two eyes(both dominant eyes) lost one line of corrected distance visual acuity(CDVA), while the remaining eyes(38/40) maintained or gained lines of CDVA. The average binocular uncorrected distance visual acuity improved from 0.15±0.03 to 0.90±0.26(decimal vision;P<0.001). The average binocular uncorrected near visual acuity increased from 0.34±0.28 to 0.97±0.07(P<0.001). The spherical aberration was 0.04±0.06 μm in the nondominant eye and 0.09±0.09 μm in the dominant eye(P=0.02). All patients were satisfied with or accepted the outcomes of the surgery. The primary complaints were related to disturbances in night vision and relatively inferior near vision.CONCLUSION: Over the one-year observation period, PRESBYOND is a safe and effective option for presbyopia correction. The optical quality and near vision deserve further investigation.
文摘●AIM:To analyze one year clinical outcomes and subjective rating of hybrid bi-aspheric multifocal central presbyLASIK with micro-monovision for correction of presbyopia and myopic astigmatism.●METHODS:Seventy-four eyes of 37 patients consecutively treated with presbyLASIK were assessed.The mean age of the patients was 43.8±3.0 y with a mean spherical equivalent refraction of-5.21±1.87 diopters(D)and mean astigmatism of-0.82±0.64 D.Visual acuity,manifest refraction,contrast sensitivity,aberrometry and patients’subjective rating were evaluated pre-and postoperatively.●RESULTS:At 1 y postoperatively(68 eyes of 34 patients),the mean spherical equivalent(SE)refraction in distance eyes was 0.06±0.05 D,whereas the achieved SE in near eyes was-0.83±0.05 D.Ninety-nine percent of eyes were within±0.50 D of target correction of SE.The binocular mean uncorrected distance visual acuity(UDVA)was 0.00±0.18 logMAR(20/20).Sixty-four percent of patients achieved 0.0 logMAR(20/20)or better of UDVA and 0.1 logRAD or better of UNVA as well.There was a binocularly loss of one line CDVA after surgery for only one patient(3%,1/34)and no patient lost 2 lines.The changes in binocular contrast sensitivity(CS)in all test conditions were not significant at any frequency after surgery.The changes of entire eye total higher order aberrations(tHOA)and spherical aberrations(SA)significantly higher in near eyes than in distance eyes.The overall satisfaction score for surgery was 93±8.●CONCLUSION:The hybrid bi-aspheric multifocal central presby LASIK with micro-monovision appears to be an efficacious option for myopic presbyopes.One year postoperative outcomes in a relatively young presbyopia population indicate improvements in both far and near vision with high satisfaction.
基金Supported by the Dong-A University Research Fund.
文摘AIM:To assess the clinical performance of a multifocal corneoscleral lens for the presbyopia correction.METHODS:A prospective clinical trial of the OnefitTM A multifocal corneoscleral lens was conducted with 40 participants with presbyopia.At 4 wk of continuous wear of the corneoscleral lens,changes in the distance,intermediate,and near visual acuity(VA)were evaluated.The safety of the corneoscleral lens,central corneal thickness(CCT),corneal endothelial cell count,binocular stereopsis,tear film break-up time(BUT),corneal staining,corneal edema,corneal neovascularization(NV),and conjunctival hyperemia were examined.In addition,a subjective questionnaire addressing satisfaction(rated from 1 to 5 points)and discomfort(rated from 1 to 5 points)was administered.RESULTS:Forty participants were enrolled in this study.Six participants were excluded because of poor compliance with lens fitting(n=2)and loss to follow-up(n=4).The mean age of the participants was 53.0±4.9 y.At 4 wk of continuous wear of the corneoscleral lens,the best corrected far,intermediate,and near VA was 0.08±0.11,0.10±0.12,and 0.10±0.12 log MAR,respectively.These results were significant improvements over the baseline uncorrected VA(far:P=0.004;intermediate:P=0.004;near:P=0.002).CCT,corneal endothelial cell count,binocular stereopsis,BUT,corneal staining,corneal edema,corneal NV,and conjunctival hyperemia were not significantly different between baseline and after corneoscleral lens use.The average satisfaction scores for fit sensation;corrected far,intermediate,and near VA;and ease of handling were 4.1,3.4,3.6,3.5,and 3.4,respectively.The average discomfort scores for dryness,irritation,foreign body sensation,redness,fogging,and halo were 1.7,1.8,1.5,1.7,1.7,and 1.3,respectively.CONCLUSION:Far,intermediate,and near VA are improved in presbyopic patients with the multifocal corneoscleral lens compared to uncorrected baseline VA,without adverse ocular effects.This evidence supports the safety and effectiveness of presbyopia correction with multifocal corneoscleral lenses.
文摘Background:Presbyopia,a common age-related condition affecting near vision,impacts over a billion people worldwide.The aim of this paper is to review the main reports and results of clinical trials,comparing the newest pharmacological treatment options for presbyopia,their mechanisms of action,and possible side effects.Main text:Pharmacological approaches,involving eye drops that target the underlying mechanisms of presbyopia,have gained growing interest.Two key pharmacological agents in this field are miotics and lens softeners.Miotics enhance near vision temporarily by creating a pinhole effect,though they may cause side effects and are under further investigation for long-term use with ongoing research also exploring the potential benefits of combining them with other drugs to improve outcomes and reduce adverse reactions.Lens softeners,on the other hand,aim to restore the flexibility of the lens,addressing one of the primary causes of presbyopia.Despite early trials,further development of lens softeners has been suspended.A notable advancement in this field is the recent FDA approval of 1.25%and 0.4%pilocarpine,a miotic agent,for presbyopia treatment.This milestone highlights the growing interest in pharmacological solutions for presbyopia,with several new drugs and their combinations currently being investigated for potential FDA approval.Conclusions:pharmacological treatments,particularly miotics like pilocarpine,represent a promising alternative to conventional methods for managing presbyopia.Continued research into these treatments,especially combinations of drugs,may offer more effective and convenient options for presbyopia patients in the future.
文摘Presbyopia corrections traditionally have been approached with attempts to exchange power,either at the cornea or the lens planes,inducing multifocality,or altering asphericity to impact the optical system.Treatments that affect the visual axis,such as spectacle and contact lens correction,refractive surgeries,corneal onlays and inlays,and intraocular lenses are typically unable to restore true accommodation to the presbyopic eye.Their aim is instead to enhance‘pseudoaccommodation’by facilitating an extended depth-of-focus for which vision is sufficient.There is a true lack of technology that approaches presbyopia from a treatment based or therapy based solution,rather than a‘vision correction’solution that compromises other components of the optical system.Scleral surgical procedures seek to restore true accommodation combined with pseudoaccommodation and have several advantages over other more invasive options to treat presbyopia.While the theoretical justification of scleral surgical procedures remains controversial,there has nevertheless been increasing interest and evidence to support scleral surgical and therapeutic approaches to treat presbyopia.Enormous progress in scleral surgery techniques and understanding of the mechanisms of action have been achieved since the 1970s,and this remains an active area of research.In this article,we discuss the historic scleral surgical procedures,the two scleral procedures currently available,as well as an outlook of the future for the scleral surgical space for treating presbyopia.
文摘Background:To test and compare in a masked fashion the efficacy of using a parasympathomimetic drug(3%carbachol)and an alpha-2 agonist(0.2%brimonidine)in both combined and separate forms to create optically beneficial miosis to pharmacologically improve vision in presbyopia.Methods:A prospective,double-masked,randomized,controlled clinical trial was conducted.Ten naturally emmetropic and presbyopic subjects between 42 and 58 years old with uncorrected distance visual acuity of at least 20/20 in both eyes without additional ocular pathology were eligible for inclusion.All subjects received 3%carbachol and 0.2%brimonidine in both combined and separate forms,3%carbachol alone and 0.2%brimonidine(control)alone in their non-dominant eye in a crossover manner with one week washout between tests.The subjects’pupil sizes and both near and distance visual acuities will be evaluated pre-and post-treatment at 1,2,4,and 8 h,by a masked examiner at the same room illumination.Results:Statistically significant improvement in mean near visual acuity(NVA)was achieved in all subjects who received combined 3%carbachol and 0.2% brimonidine in the same formula compared with those who received separate forms or carbachol alone or brimonidine alone(P<0.0001).Conclusion:Based on the data,the combined solution demonstrated greater efficacy than the other solutions that were tested.Improving the depth of focus by making the pupil small caused statistically significant improvement in near visual acuity,with no change in binocular distance vision.Trial registration:ACTRN12616001565437.Registered 11 November 2016.
文摘The main purpose of this review is to compare and analyze the results of the main PresbyLASIK approaches;central and peripheral.Summary:A comprehensive research was conducted in PUBMED using keywords like“presbyopia correction”,“PresbyLASIK”,“Corneal multifocality”,“Laser blended vision”.We reviewed the PresbyLASIK technique,uncorrected distance visual acuity(UDVA),corrected distance visual acuity(CDVA),uncorrected near visual acuity(UNVA),and corrected near visual acuity(CNVA),and compared the differences between the techniques.
文摘Introduction:Presbyopia affects people from the 4^(th) decade of life and is characterized by accommodative loss that leads to negative effects on vision-targeted health-related quality of life.A non-invasive pharmacological treatment providing near-lenses independence would be a truly groundbreaking approach in the treatment of presbyopia.The purpose of this review is to analyze the emerging pharmacological solutions proposed to address presbyopia.Results:Several ophthalmic eye drops compounds solutions have been described in peer-reviewed papers or presented in ophthalmological tabloids and congresses.Each topical treatment deals with drug combinations aimed to modify one or more factors involved in the accommodative process and have been proposed to be instilled either monocularly or binocularly.It remains unclear how much each drug in the final combined form is involved in the achievement of the outcome and contributes to it.Conclusion:Despite the lack of a completely well understood mechanism,pharmacological control of presbyopia seems to be a possible and very attractive alternative for presbyopic patients.The studies mentioned in this review are to be considered pilot investigations as they involve either a small number of subjects or are single case series.Complete studies are needed to confirm which will be the more effective pharmacological compound for the treatment of presbyopia.
基金the National Natural Science Foundation of China(Grant No.81970779 to Zhu Yanan).
文摘Background:Presbyopia has become a global disease affecting the world's aging population.Among various treatments,cataract extraction and intraocular lens(IOL)implantation have become the most popular and common methods of presbyopia correction.During the twentieth century,IOLs have underwent significant innovation and advancements to meet the patients'high demands for functional vision at all distances.Main Text:To meet the increasing needs for excellent near and intermediate vision for daily activities,some premium IOLs with more than one focus have been developed,for example,the refractive MfIOLs,diffractive MfIOLs,extended depth of field(EDOF)IOLs,and accommodating IOLs(AIOLs)were introduced to meet this need.In addition,the add-on MfIOLs have been explored as promising supplementary IOLs for pseudophakic presbyopia.When selecting the MfIOLs,the IOLs'features,patients’characteristics,preoperative eye conditions,and treatment expectations should be considered.Conclusions:In this review,we focus on the multifocal IOLs(MfIOLs)commonly used for presbyopia correction and systematically summarized their optical designs and clinical outcomes.More evidence-based studies are required to provide guidelines for MfIOL selection,provide maximum visual benefits,and develop personalized visual solutions in the future.
文摘Background:The accommodation has considerable interactions with the pupil response,vergence response and binocularity.The transformation of visual reception processing and the changes of the binocular cooperation during the presbyopia development are still poorly studied.So,the regularities of visual system violation in the presbyopia formation need to be characterized.This study aims to reveal the transformation of visual reception processing and to determine the role of disturbances in binocular interactions in presbyopia formation.Methods:This study included 60 people with emmetropic refraction,uncorrected distance visual acuity 1.0 or higher(decimal scale),normal color perception,without concomitant ophthalmopathology.The first group consisted of 30 people(from 18 to 27 years old)without presbyopia,the second cohort comprised 30 patients(from 45 to 55 years old)with presbyopia.The eyeball anatomy and optics were evaluated using ultrasound biomicroscopy,aberrometry,and pupillometry.The functional state of the visual system was investigated under monocular and binocular conditions.The registration of the disparate fusional reflex limits was performed by the original technic using a diploptic device which facilitated investigation of the binocular interaction under natural conditions without the accommodation response,but with the different vergence load.The disparate fusional reflex was analyzed using the proximal and distal fusion borders,and the convergence and divergence fusion borders.The calculation of the area of binocularity field was performed in cm2.Results:The presbyopia formation is characterized by a change in an intraocular anatomy,optics,visual processing,and binocularity.The processes of binocular interaction inhibition make a significant contribution to the misalignment of the visual perception.The modification of the proximal,distal and convergence fusion borders was determined.It was revealed that 87%of the presbyopic patients had binocularity shortage,whereas the reduction of binocularity field area in extreme grade was seen in 6%of cases.Conclusions:The presbyopia formation is accompanied by a significant reorganization of the visual system activity and by the creation of the new visual processing interactions.These data may be useful in presbyopia surgery.
