December 2002
Volume 43, Issue 13
Free
ARVO Annual Meeting Abstract  |   December 2002
Assessing Accommodation After A Scleral Buckling (sb) Procedure
Author Affiliations & Notes
  • JP McDonald
    Ophthal & Vis Sci University Wisconsin Madison Madison WI
  • MA Croft
    Ophthal & Vis Sci University Wisconsin Madison Madison WI
  • I Muasher
    Chicago IL
  • BL Larson
    University of Illinois Chicago Chicago IL
  • PL Kaufman
    Ophthal & Vis Sci University Wisconsin Madison Madison WI
  • Footnotes
    Commercial Relationships   J.P. McDonald, None; M.A. Croft, None; I. Muasher, None; B.L. Larson, None; P.L. Kaufman, None. Grant Identification: NEI Grant EY10213
Investigative Ophthalmology & Visual Science December 2002, Vol.43, 1487. doi:
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    • Get Citation

      JP McDonald, MA Croft, I Muasher, BL Larson, PL Kaufman; Assessing Accommodation After A Scleral Buckling (sb) Procedure . Invest. Ophthalmol. Vis. Sci. 2002;43(13):1487.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Abstract: : Purpose:SB has been reported to induce myopia at least in part by increasing anterior-posterior axial globe length. None of these studies report measurements of accommodation. A 53 year-old male patient reported the unusual ability to see clearly at near in the operated eye (OD) following standard SB with the distance spectacle correction in place; not noted prior to SB and not noted in the unoperated eye (OS). Our goal was to determine if true accommodation was occurring in this patient, and if so, by what mechanism. Methods:Two drops of 4% pilocarpine HCl (PILO, 10 min interval) were given in the operated eye (OD) only. Refraction (coincidence refractometry) and intraocular distances (A-scan ultrasonography) were measured immediately prior to and ∼1 hr post-PILO in both eyes. Accommodation was calculated by subtracting the pre-PILO from the post-PILO refraction. Results:Pre-PILO distance refraction was -4.75 D and -1.0 D in OD and OS respectively, giving Snellen VA of 20/40 and 20/20. Pre-PILO anterior chamber (AC) depth in both eyes was identical (3.41mm ± 0.03{mean ± s.e.m.}); the lens was thicker in OD (4.41 ± 0.00 vs 4.23mm ± 0.06) by 0.18 mm; the OD globe was longer (26.16 ± 0.04 vs 24.98 ± 0.02 mm) by 1.18mm. PILO induced 4.25 D of accommodation OD (outside the range of a normal 53 yr old according to Duane’s curve), the AC shallowed by 0.57 mm, the lens thickened by 0.18mm, and the globe length remained the same. The left (untreated) eye did not accommodate following PILO OD and the intraocular distances were unchanged. Conclusion:The myopic shift following SB may be due not only to increased globe length but also to lens thickening. The PILO induced accommodation may be true accommodation since the AC shallowed and the lens thickened. The mechanism by which this occurs may bear on other present and potential procedures designed to correct presbyopia. Ultrasound biomicroscopy will be performed to verify ciliary muscle and scleral configuration, and to further elucidate the mechanism of accommodation in this presumably once presbyopic eye.

Keywords: 304 accommodation • 309 aging • 563 retinal detachment 
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