Surgical Reversal of Presbyopia (SRP)
Surgical Reversal of Presbyopia (SRP) was developed by Presby Corp. It involves the use of a device known as a scleral expansion band (SEB) implanted in the white portion of the eye (sclera). This band increases the distance between the lens and sclera, allowing the muscles between them to bend and flatten the lens as necessary. Clinical trials are currently being conducted across the U.S. A main concern is the longevity of the effect.
There are several expected benefits to this surgery:
- Long-term vision correction – SRP is expected to benefit the patient for a number of years.
- Low risk – SRP is performed on the sclera, an area that is rarely associated with complications.
- Minimally invasive – SRP can be performed on an outpatient basis under local anesthesia with a surgery time of 30 minutes per eye.
- Reversible – unlike laser surgery, this procedure is expected to be fully reversible – the implants should be removable at any time.
- Reduction of intraocular pressure – preliminary studies have indicated that the surgery reduces intraocular pressure in patients with primary open angle glaucoma and ocular hypertension
Anterior Ciliary Sclerotomy (ACS)
Anterior Ciliary Sclerotomy (ACS) is an experimental procedure that is used to reduce the effects of presbyopia. A series of eight or more radial incisions are made in the sclera of the eye, allowing it to expand and giving the eye more room to bend and flatten the lens as necessary. ACS does not restore all near vision and it is not a cure for presbyopia, but it does offer some improvement in focusing ability. The FDA considers the procedure investigational, but approval is not necessary since the FDA approves surgical devices and drugs, not surgical procedures. It is not widely used as an option yet.
OptiVision Presbyopia Surgery
OptiVision presbyopia surgery involves the use of a laser to correct vision. The eye surgeon ablates tissue on the white portion of the eyes, expanding the sclera and giving the lens more flexibility. OptiVision is currently undergoing clinical trials in Canada and other parts of the world and in the U.S. SurgiLight, the maker of the laser system, hopes to begin FDA clinical trials in the near future.
When To Call A Professional
Although there is no harm in delaying treatment for presbyopia, optometrists recommend seeing a professional whenever you have blurred vision because this can indicate other vision or health problems. For example, cataracts also can cause blurred vision, and diabetes, multiple sclerosis, vascular disease and other diseases can affect vision. *** If your vision suddenly blurs, or if you have eye pain or double vision, see black spots or light flashes or have other visual problems, see your doctor immediately.
Prognosis of Presbyopia
The condition will persist, get worse, then stabilize in the mid to late 60’s. With proper corrective glasses or contact lenses, you’ll still be able to read and do other close work as well as ever, provided no other conditions exist which may reduce your vision.. This information is intended to provide a brief overview of presbyopia. Contact an Ophthalmologist or eye care professional for information specific to your own situation.
How the Eyes Work & See The eye can be likened to a camera. As light passes through the cornea and lens it is bent and transposed / focused onto the eye’s film – the retina. The film is then ‘developed’ by the brain, becoming the image that we see and interpret. As light enters the eye it first passes through the cornea – the clear ‘window’ to the eye. Because the cornea is curved, the light rays bend (refract). Light then passes through the pupil to the lens. The iris – the colored portion of the eye – controls the amount of light that enters the eye with muscles that cause the pupil to contract if there is too much light or to dilate if there is too little light. When light hits the curved surface of the lens it is refracted, or bent even more, so that it focuses properly on the retina. The retina then turns the light into electrical energy, which passes through the optic nerve to the brain stem, and into the occipital lobe where it is converted into an image. To summarize:
- Cornea – clear surface of the eye. Light rays refract as they pass through to the pupil.
- Iris – colored portion of the eye. The iris controls the amount of light that passes through the pupil.
- Pupil – an open space in the center of the iris. Light passes through the pupil to the lens.
- Lens – refracts light to focus it properly on the retina.
- Retina – converts light rays into electrical energy. This electrical energy is passed to the optic nerve.
- Optic Nerve – serves as a pathway to the brain stem, which forwards electrical energy to the occipital lobe.
- Occipital Lobe – electrical energy is converted into an image.
- This process works perfectly in people with 20/20 vision. Imperfect vision occurs when the shape of the eye is irregular or when the eyeball length is above or below average, so that the light rays do not focus directly on the retina – these imperfections are collectively known as refractive errors.