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Contraindications to the surgical reversal of presbyopia.

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Age related loss of accommodation

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Schachar theory of accommodation

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Schachar theory of accommodation

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Anatomical changes in relationship between ciliary body and lens with age

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Anatomical changes in relationship between ciliary body and lens with age

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Chart comparing Helmholtz and Schachar theories of accommodation

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Surgical reversal of Presbyopia

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Implantation of intrascleral expansion band segments to reverse presbyopia

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Implantation of intrascleral expansion band segments to reverse presbyopia

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1. Two radial incisions are placed with a RK knife. Each incision is situated 2.75 mm behind the surgical limbus and is approximately 900 microns wide. The two incisions are separated by 4.0 mm.
2. A diamond knife is then used to dissect between the two radial incisions to create an intrascleral tunnel.
3. Using a needle holder a scleral expansion segment is placed into the tunnel starting at the exit wound of the diamond knife and proceeding towards the entrance wound of the diamond knife.
4. Completed placement of intrascleral expansion segment.

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1. Two radial incisions are placed with a RK knife. Each incision is situated 2.75 mm behind the surgical limbus and is approximately 900 microns wide. The two incisions are separated by 4.0 mm.
2. A diamond knife is then used to dissect between the two radial incisions to create an intrascleral tunnel.
3. Using a needle holder a scleral expansion segment is placed into the tunnel starting at the exit wound of the diamond knife and proceeding towards the entrance wound of the diamond knife.
4. Completed placement of intrascleral expansion segment.

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Postoperative appearance of implanted scleral expansion segments. Note that they are not visible in normal gaze. However, the outlines of the segments can be made out through the conjunctiva and sclera in either up gaze or down gaze under careful observation.

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Postoperative appearance of implanted scleral expansion segments. Note that they are not visible in normal gaze. However, the outlines of the segments can be made out through the conjunctiva and sclera in either up gaze or down gaze under careful observation.

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Contraindications to the surgical reversal of presbyopia.

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