Models of Accommodation Deficiency in Presbyopia Patients

Purpose: We describe new phenomenological illumination-dependent static models of the accommodation deficiency for patients with presbyopia. Such models are suitable for vision restoration with adaptive-optics accommodating eyeglasses and contact lenses. Methods: Data from fifteen participants over the age of 45 and diagnosed with presbyopia was collected. Participants were asked to wear a pair of mechanically-tunable eyeglasses and clearly identify the optotypes corresponding to the LogMAR 0.0 line on Early Treatment of Diabetic Retinopathy Study (ETDRS) charts, by suitably adjusting the optical powers of the lenses on these tunable eyeglasses for each measurement. Seven ETDRS charts, placed at distances from the patients varying from 4 m through 30 cm, were used under three chart illumination levels (75 lx, 500 lx and 800 lx). The optical power of the lenses in the patient-adjusted tunable eyeglasses was subsequently measured using a Shack-Hartman wavefront sensor for each chart, which provided the accommodation deficiency data of the participants. Results: The measured accommodation deficiency data from 15 presbyopes was curve-fitted to a model for each patient. The calculated root-mean-square error values for the fitted models ranged between 0.09 D - 0.67 D over a 3.08 D accommodation stimulus range. Conclusions: The data shows that while accommodation deficiency in humans is a function of the stimulus, it is also strongly dependent on the object illumination and age of the patients. The models adequately describe the relation between static accommodation deficiency, accommodation stimulus and object illumination.

The Predictability of Preoperative Pilocarpine-Induced Lens Shift on the Outcomes of Accommodating Intraocular Lenses Implanted in Senile Cataract Patients

Purpose. To evaluate the predictability of lens shift induced by pilocarpine (LSPilo) on the outcomes of accommodating intraocular lens (Acc-IOL) implantation.Methods. Twenty-four eyes of 24 senile cataract patients who underwent phacoemulsification and Acc-IOL implantation were enrolled.LSPilowas evaluated with anterior segment optical coherence tomography (AS-OCT). At 3 months postoperatively, the best corrected distance visual acuities (BCDVA), distance-corrected near visual acuities (DCNVA), and subjective and objective accommodations were measured. IOL shifts under accommodation stimulus (IOLSAcc) were evaluated with AS-OCT.Results. The meanLSPilowas 112.29 ± 30.72 µm.LSPilowas not associated with any preoperative parameters. The meanIOLSAccwas 130.46 ± 42.71 µm. The mean subjective and objective accommodation were 1.54 ± 0.39 D and 1.27 ± 0.41 D, respectively. The mean postoperative BCDVA and DCNVA (log MAR value) were 0.22 ± 0.11 and 0.24 ± 0.12, respectively.LSPilopositively correlated withIOLSAcc(r=0.541;P=0.006), subjective accommodation (r=0.412;P=0.022), and objective accommodation (r=0.466;P=0.045), respectively.Conclusion.LSPilois an independent preoperative parameter associated with the postoperative Acc-IOL mobility and pseudophakic accommodation. It may offer valuable information for ophthalmologists in determining the suitable candidates for Acc-IOL implantation.