Synchrony dual optic accommodating lens

Nevertheless, pseudoaccommodation is not a real restoration of accommodation [1, 5].

Current non-surgical treatment options include reading spectacles (either mono or varifocal) and contact lenses (either multifocal or monofocal for monovision), but many of these patients, spectacle independent previously, do not easily accept this unavoidable age-related life style change.

While corneal procedures for presbyopia are still under a serious debate regarding their long term outcomes and success rate, current surgical options mostly include refractive lens exchange by either monofocal IOLs for monovision or multifocal IOLs.

Obviously, this ideal AIOL would have a huge impact in refractive surgery and private practice, which explains the interest from the different companies in developing such lenses.

This ambition has led to many mistakes in the past (commercial bias, poor methodology to study near vision, non-independent monitorization, etc.), where different types of AIOLs were presented to the scientific community as highly effective to be then discredited later on by independent studies from different authors.

It is likely that the ultimate mechanism for presbyopia is a culmination of many factors together resulting in a loss of accommodative amplitude (multifactorial theory).

However, it is unclear if these documented changes in the ciliary muscle and the lens sclerosis occur together or if one is a consequence of the other.Almost all surgical techniques that have been proposed to date for the surgical correction of presbyopia are based on the acquirement of pseudoaccommodation [1].Pseudoaccommodation comprises a group of techniques that can improve near vision on the basis of the use of the cornea or intraocular lenses (IOLs), resulting in an increased depth of field, multifocality or both [2].Presbyopia still remains the last frontier of refractive surgery.Its surgical management is under constant evolution due to the limitations that exist today with respect to its management, which is probably in relation with the multifactorial basis in which presbyopia is clinically developed in the human.Helmholtz (1856) proved that accommodation is accomplished by the change of the power of the crystalline lens associated with the active action of the ciliary body.


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