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Surgical Reversal of Presbyopia Astigmatism Complications

Before we discuss the surgical reversal of presbyopia astigmatism complications, perhaps we should have a little background on what this means.

Presbyopia Astigmatism

Accommodation, when used in relation to the eyes, describes the process by which the eye increases its power to enable clear near vision. Because the eye's lens position is fixed, it has to alter its shape in order to focus on objects of varying distance. This can also be described as increasing its power. As people get older, this ability decreases, and older people find it harder to focus clearly on near objects. When a person is unable to focus on near objects because of insufficient accommodation ability, then 'Presbyopia' is said to have set in.

People start to notice this problem when they reach 40, and is often first noticed when they have difficulty reading, and spectacles are usually required for reading.

A presbyopic eye cannot clearly see all objects that are located at different distances. Some objects will remain focused, but not all.

Surgical Reversal

The surgical reversal of presbyopia with the insertion of scleral expansion band (SEB) segments is a delicate and precise procedure. But, there are surgical considerations to keep in mind to avoid complications. In addition to the primary objective of reversing presbyopia, one of the major advantages of this procedure is its safety and reversibility.

However, if the procedure is not approached as a surgical procedure, then problems can arise. This procedure has the great advantage of affecting neither distance vision nor refractive error.

The only 2 major complications reported with this procedure (as of April, 2001) have been a single case of endophthalmitis and one case of anterior segment ischemia. The surgeon and surgical team should approach this just as they would any intraocular procedure. It inadvertently can become an intraocular procedure when the segments are inserted too deeply and penetrate into the suprachoroidal space. Vitreous can be lost in these situations, but loss is minimal and easily tamponaded by the segment. The barrier of the intact eye has been compromised; therefore, infection is possible. With good sterile technique, endophthalmitis should not occur.

The details of the surgical reversal have come courtesy of Gene Zdenek, MD, Medical Director, Chief of Staff, Surgi-Eye-Center; Clinical Instructor, Department of Family Practice, Northridge Hospital Medical Center.

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The article was written by Charlie Cory, who is the owner of FX Eyes, a website dedicated to providing advice about buying special effects contact lenses online.

You can visit his website about special effects contact lenses.