Evaluation of age-related changes on human ocular accommodation biomechanics using high frequency ultrasound biomicroscopy (UBM)

Session Details

Session Title: Presbyopia Correction

Session Date/Time: Tuesday 13/09/2016 | 16:00-18:00

Paper Time: 16:00

Venue: Auditorium A

First Author: : D.Goldberg USA

Co Author(s): :    A. Hipsley   R. Ang   E. Pfeiffer              

Abstract Details

Purpose:

Our purpose was to measure accommodation in phakic eyes human eyes in 2 groups comparing young/healthy adult eyes to old/presbyopic adult eyes to explore changes in the anterior segment anatomy by UBM imaging.

Setting:

Pilot Study Asian Eye Institute Makati City, Phillipines

Methods:

20 eyes (10 patients) were enrolled in the study: Group 1(Young/healthy): 27-32 years old; Group 2(Old/Presbyopic): 45-55 years old. Pre-operative best corrected visual acuity: 20/25 or better. Dynamic accommodative response (AR) was stimulated utilizing a laser pointer as the far target and an ETDRS card fixed at 40cm as a near target. Biometric changes of AR in the anterior segment were measured by UBM in an accommodation-solicited condition and in a relaxation state as follows: a) scleral-ciliary angle structures; b) anterior and posterior (AP) lens surfaces c) lens thickness. Individual UBM images and raw data of video loops were analyzed.

Results:

Various intraocular distances were evaluated based on a literature review of age-related anatomical changes. We observed a decrease in the distance between the ora serrata or the insertion zone identified by Croft et al (IOVS JUL 2013) as the ‘Posterior insertion zone of the Vitreous Zonule’ (PIVZ) and (a) scleral spur, (b) the ciliary muscle apex; (c) the circumlental space as well as decrease in the relative AP movements of the lens surfaces in all of the subjects in Group 2 (older/presbyopic) upon solicited accommodation.

Conclusions:

Biometric changes in the scleral ciliary angle and AP lens surfaces can be dynamically quantified with UBM by observing and identifying specific anatomical relationships which are affected by age. Almost all of the anatomical structures both lenticular and extralenticular structures appear to be affected by age in our study and appear to contribute in each’s own way to the age-related loss of accommodation which occurs with age. UBM appears to be a reliable method to measure these changes and evaluate the mechanisms that are contributing to the age-related biomechanical dysfunction in the accommodative system.

Financial Disclosure:

... receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented, ... research is funded, fully or partially, by a company producing, developing or supplying the product or procedure presented