Tetraflex accommodating

However, it is unclear if these documented changes in the ciliary muscle and the lens sclerosis occur together or if one is a consequence of the other. Thus, the ideal AIOL would fully resolve the inconvenience of presbyopia and the side effects in relation with current surgical options as the positive visual symptoms or the deterioration of quality of vision after multifocal IOL implantation.

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It is likely that the ultimate mechanism for presbyopia is a culmination of many factors together resulting in a loss of accommodative amplitude (multifactorial theory).This concept refers to any other method that changes the power of the whole optical system of the eye or changes partly the way in which it works in order to relieve patients for near distance vision.Nevertheless, pseudoaccommodation is not a real restoration of accommodation [The theory of accommodation is largely based on Helmholz's ideas: the capsule has sufficient elasticity to mold the lens into a more strongly curved system than what is necessary for distance vision.In this article, we will update the modern refractive surgeon about the fundamentals and provide updated information about the outcomes of AIOLs by reviewing the concept of accommodation, the different attempts that have been accomplished in the past, their demonstrated published results in human clinical trials, and the future alternatives that may arrive in the near future.Presbyopia is the physiological degradation of accommodation and still remains as the last frontier of refractive surgery as its surgical management is perhaps the most innovative and challenging and is under constant renewal.This ambition has led to many mistakes in the past (commercial bias, poor methodology to study near vision, non-independent monitorization, etc.), where different types of AIOLs were presented to the scientific community as highly effective to be then discredited later on by independent studies from different authors.After multiple failures, the question arises if AIOLs replicating the mechanism of accommodation could actually be developed.The change in the refractive power of the eye, when the image of a near object is brought into focus on the retina, is defined as accommodation; such a process must involve an increase in the dioptric power of the system [ It is the difference in refractive power of the eye in the two states of complete relaxation and maximal accommodation.The amplitude of accommodation decreases progressively with age (presbyopia): in a ten year old child it is, on average, about 14 D; at forty it is 6 D; and at 60 it is only about 1 D.Almost all surgical techniques that have been proposed to date for the surgical correction of presbyopia are based on the acquirement of pseudoaccommodation [].Pseudoaccommodation comprises a group of techniques that can improve near vision on the basis of the use of the cornea or intraocular lenses (IOLs), resulting in an increased depth of field, multifocality or both [].

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