Analysis of Accommodation Gain of Presbyopia Eye After Laser Ablation (or Shrinkage) of Sclera Via Lens Reshaping and Lens Anterior Shift

Purpose: To derive and provide analytic formulas for an accommodative gain of presbyopia eyes. via sclera ablation and/or thermal shrinkage such that the lens is reshaped and/or its position is shifted. New mechanisms are also proposed.

Study Design: To increase the accommodation of presbyopia.

Place and Duration of Study: New Taipei City, Taiwan, between June 2021 and July 2021.

Methodology: Accommodation gain is calculated by a 4-component theory, in which the rate functions are derived by an effective eye model for the change of anterior curvature of the lens and its anterior shift. The measured data of accommodative response of the lens versus the lens curvature change and anterior shift are analyzed. The measured net change of the posterior vitreal zonules (PVZ) length and the space between the ciliary body and lens (CLS) during the accommodation are also analyzed.

Results: The accommodative gain (AG) is mainly due to the change of lens anterior curvature and its anterior shift. The AG per diopter change of the reshaped lens is 0.62 to 0.68 by our formulas, comparing to the measured average value M'=0.69.The efficacy of LASA (or AG) is proportional to the amount of scleral tissue removed (or shrinkaged), such that more space is produced for the change of PVZ and CLS from a UCS to AS for accommodation.

Conclusion: The AG is proportional to the amount of scleral tissue removed (or shrinkaged), such that more space is produced for the change of PVZ and CLS from a UCS to AS for accommodation.