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Study of Theoretical Basis of Scleral Expansion Surgery for Reversal of Presbyopia 1. Xiaobing Wang¹ ¹Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China Purpose The scleral expansion surgery for reversal of presbyopia, which was based on a new theory of human eye accommodation, has got certification in Europe and has been restarted for FDA clinical trial in USA. However, controversy on this surgery has never been stopped. In this study, in vivo measurement result of shape change of crystalline lens with big and stable accommodation was measured by magnetic resonance imaging (MRI) to help to clarify the accommodation mechanism. Methods By three years' screening, a 25 years-old woman who suffered from lasting accommodative strain (stay at a lasting accommodation state) of eyes was screened out. The amplitude of accommodative strain of her right eye and left eye were 10.00DS and 8.00DS respectively, and her accommodative strain of eyes could be completely relieved by application of atropine eye drops. A General Electric, 1.5-Tesla MR imager and a custom-designed eye imaging coil were used to collect high-resolution MRI images of crystalline lens of her eyes before and after atropine eye drops application. Results The measurement results showed clearly that the diameter of crystalline lens of her both eyes increased after application of atropine eye drops, and the thickness from equator to the center of crystalline lens of her both eyes decreased after application of atropine eye drops. Conclusions Our measurement results do not support the new accommodation theory but support the traditional theory, and suggest that the presbyopia surgery based on the new theory should be studied more carefully before being performed on human patients. |
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