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K. Park, J. Yun, J. Yim, C. Kee; The Effect of Cataract Extraction on the Contractility of Ciliary Muscle Induced by Pilocarpine in Presbyopia. Invest. Ophthalmol. Vis. Sci. 2007;48(13):3826.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the change of contractility of ciliary muscle induced by pilocarpine in eyes with presbyopia before and after cataract extraction by ultrasound biomicroscopy (UBM).
Clear corneal phacoemulsification with posterior chamber intraocular lens (AcrySof SA60AT, Alcon Laboratories) implantation was performed in 8 eyes of 8 subjects. UBM was performed with and without 2 % pilocarpine instillation, before and 2 months after cataract extraction. Mean (±standard deviation) age was 62.25±6.0 years (range; 58-75 years). At each examination, images of the iridocorneal angle including ciliary muscle at the superior, inferior, temporal, and nasal quadrants were obtained. Axial length of ciliary body (CBAXL) and ciliary process-sclera angle (CPSA) were measured. Images of ciliary muscle were compared visually by Adobe Photoshop 7.0, and measured parameters were analyzed by paired t-test.
CBAXL value with and without pilocarpine before cataract extraction was 1709±145 µm and 1700±157 µm, respectively, and this increase with pilocarpine instillation was not statistically significant (P=0.665). CBAXL value with and without pilocarpine after cataract extraction was 1774±203 µm and 1634±158 µm respectively, and this increase with pilocarpine instillation was statistically significant (P=0.033). Cataract extraction led to a significant increase of CPSA with and without pilocarpine instillation by 8.0±4.0°and 7.1±4.4°, respectively compared with those before cataract extraction (P=0.001 and P=0.000, respectively). Visually compared configurations of ciliary muscle changes were compatible with the analysis of measured parameters.
Ciliary muscle moved more forwardly by pilocarpine before cataract extraction, however pilocarpine induced inward movement of ciliary muscle increased after cataract extraction. This finding shows that a lenticular sclerotic component influences the contractility of ciliary muscle, and is related to the presbyopia.
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