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To clarify dynamic, self-regulating mechanisms of presbyopia and to evaluate a presbyopic surgical procedure which restores binocularity.
Patients (n=10) with a range of refractive error without concomitant pathology were examined. The functional state of the visual system in monocular and binocular conditions was investigated using ultrasound biomicroscopy, Schleimpflug imaging, aberrometry, standard ETDRS charts, and pupillometry. Evaluation of the effects of the Laser Scleral Microporation (LSM) procedure on binocularity and stereopsis of 10 patients was also performed.
The decrease of accommodation in presbyopia is accompanied by marked changes in the lens and ciliary muscle, an increase of optical aberrations, changes in diaphragmatic function of the pupil, specific to each of the refractive groups. The shift of image focus zone in presbyopia is accompanied by suppression of binocular cooperation. The degree of binocular summation and stereopsis are reduced. Results from a prospective single arm clinical trial are offered for 10 patients over a 3 month follow up period of presbyopic patients who were treated with the LSM procedure. Stereopsis in these patients improved as well approaching statistical significance at 3 months post operatively.
formation. Unfortunately, most current surgical presbyopia treatments reduce binocular vision, increasing the risk for dissatisfaction post-operatively. An exception is LSM, a treatment which appears not only to restore accommodative function but also binocularity and stereopsis.