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cerebus
medicine forum beginner
Joined: 22 Jun 2006
Posts: 1
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 Posted: Thu Jun 22, 2006 9:35 am Post subject:
Tell me about accomodation after cataract surgery
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I'm a 33yo male with
OD -3.75, -2.50 @ 115,
OS -4.00, -1.00 @ 120
which have been like that for over 25 years. I'm accustomed to
wearing glasses or soft contacts full time.
Since mid-March of this year, I rapidly developed a cataract in my left
eye which is now quite advanced. I've had a consultation for lens
replacement surgery with a well experienced doctor who presented both IQ
and ReSTOR options for my consideration.
Since I have young, otherwise healthy eyes, I'm uncomfortable with the
prospect of losing the ability to accomodate due to surgery. Is this a
given (is the ciliary muscle severed during the procedure)?
I want to avoid needing bifocals if possible. Does the ReSTOR simply
work as an implanted bifocal, requiring me to tilt up and down to look
out of the proper region? Is correcting the left for excellent
distance vision while keeping the right myopic a good idea? I have also
begun reading about multifocal and accomodative IOCs, but they seem like
they are still in the experimental stage. Would I be better off preserving
my ciliary muscle intact for a few more years until a truly accomodative
solution is perfected, rather than damaging it now and denying that option
in the future?
Any thoughts or insights you can offer are greatly appreciated. |
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Anon E. Muss
medicine forum Guru Wannabe
Joined: 22 May 2006
Posts: 136
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| Posted: Thu Jun 22, 2006 4:08 pm Post subject:
Re: Tell me about accomodation after cataract surgery
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On Thu, 22 Jun 2006 04:35:16 -0500, cerebus
<nswhitch@ya_nospam_hoo.com> wrote:
| Quote: | I'm a 33yo male with
OD -3.75, -2.50 @ 115,
OS -4.00, -1.00 @ 120
which have been like that for over 25 years. I'm accustomed to
wearing glasses or soft contacts full time.
Since mid-March of this year, I rapidly developed a cataract in my left
eye which is now quite advanced. I've had a consultation for lens
replacement surgery with a well experienced doctor who presented both IQ
and ReSTOR options for my consideration.
Since I have young, otherwise healthy eyes, I'm uncomfortable with the
prospect of losing the ability to accomodate due to surgery. Is this a
given
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Yes.
| Quote: | (is the ciliary muscle severed during the procedure)?
|
No.
| Quote: | I want to avoid needing bifocals if possible. Does the ReSTOR simply
work as an implanted bifocal, requiring me to tilt up and down to look
out of the proper region?
|
No. See
<http://www.acrysofrestor.com/apodization-diffraction/restor-lens.asp>.
Your eye doctor should explain how the various multifocal IOLs work so
you are well informed and can make a rational, informed decision.
| Quote: | Is correcting the left for excellent distance vision while keeping the
right myopic a good idea?
|
It may be. That is something you should discuss with your eye
doctor(s).
You need your eye doctor(s) to explain the pros/cons of the various
post-operative vision goals such as clear distance vision in the left
eye (may be spectacle intolerant due to anisekonia), clear near vision
in the left eye (require spectacles or contacts to see clearly in the
distance) or somewhere in between.
[snip]
| Quote: | Would I be better off preserving my ciliary muscle intact for a few
more years until a truly accomodative solution is perfected, rather
than damaging it now and denying that option in the future?
|
It depends on how much your cataract bothers you.
Cataracts are typically removed for two reasons:
1. It bothers the patient -- i.e., you can't see as well as you want
to and the risk:benefit ratio is acceptable to you and your eye
surgeon.
2. It bothers the eye doctor -- e.g., doctor is unable to adequately
view fundus details, waiting much longer will risk making cataract
"rock hard" which makes surgery more difficult/risk of complications,
waiting much longer incurs risk of catarct becoming
hyperacute/Morgagnian, etc.
If both (1) and (2) do not apply, then you can probably wait.
>Any thoughts or insights you can offer are greatly appreciated. |
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William Stacy
medicine forum Guru
Joined: 01 May 2005
Posts: 1177
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| Posted: Thu Jun 22, 2006 5:02 pm Post subject:
Re: Tell me about accomodation after cataract surgery
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cerebus wrote:
| Quote: | I'm a 33yo male with
OD -3.75, -2.50 @ 115,
OS -4.00, -1.00 @ 120
which have been like that for over 25 years. I'm accustomed to
wearing glasses or soft contacts full time.
Since mid-March of this year, I rapidly developed a cataract in my left
eye which is now quite advanced. I've had a consultation for lens
replacement surgery with a well experienced doctor who presented both IQ
and ReSTOR options for my consideration.
Since I have young, otherwise healthy eyes, I'm uncomfortable with the
prospect of losing the ability to accomodate due to surgery. Is this a
given (is the ciliary muscle severed during the procedure)?
No, but the artificial lens will have no focusing ability, as it will be |
a rigid lens. Your ciliary muscle will continue to constrict, but it
will have no effect on the iol shape/power (or little or no effect if it
is a hinged/moveable lens). I'm not a fan of the Restor or any
multifocal iols at this point, but you will get differing opinions. The
main problem with the Restor is the add is over 3.00 so the near focus
is much closer than necessary for most people. I'd opt for a prolate
aspheric single vision lens set for distance, and you might need some
readers to balance you at near. You might not. If and when they
perfect a multiofcal or a focusing lens, you might be a candidate for
exchanges later. Important to get a VERY GOOD surgeon.
w.stacy, o.d. |
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Neil Brooks
medicine forum Guru
Joined: 24 Mar 2005
Posts: 1148
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| Posted: Thu Jun 22, 2006 5:15 pm Post subject:
Re: Tell me about accomodation after cataract surgery
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On Thu, 22 Jun 2006 17:02:29 GMT, William Stacy <wstacy@obase.net>
wrote:
| Quote: |
cerebus wrote:
I'm a 33yo male with
OD -3.75, -2.50 @ 115,
OS -4.00, -1.00 @ 120
which have been like that for over 25 years. I'm accustomed to
wearing glasses or soft contacts full time.
Since mid-March of this year, I rapidly developed a cataract in my left
eye which is now quite advanced. I've had a consultation for lens
replacement surgery with a well experienced doctor who presented both IQ
and ReSTOR options for my consideration.
Since I have young, otherwise healthy eyes, I'm uncomfortable with the
prospect of losing the ability to accomodate due to surgery. Is this a
given (is the ciliary muscle severed during the procedure)?
No, but the artificial lens will have no focusing ability, as it will be
a rigid lens. Your ciliary muscle will continue to constrict, but it
will have no effect on the iol shape/power (or little or no effect if it
is a hinged/moveable lens).
|
So ... Doctor Bill ...
If you said what I think you just said, then you answered my $64,000
question.
The *only* place I found data was in Clyde Oyster's book, "The Human
Eye: Structure and Function" (1999) where he said, in effect, that the
ciliary ennervation never stops in presbyopia; only the accommodation
itself.
Intuitively, even before seeing that, I thought this was right.
Otherwise, something would have to "go dark" and "re-ignite" when
AIOLs were implanted.
My doc *still pushes* for me to get RLE + (preferably monofocal)
IOL's, under the premise that my accommodative mechanism will
eventually give up, thus permanently ending the spasm.
*I* think that--based on my history--giving up is *not in the lexicon
of MY* accommodative system and that putting a brick wall in front of
it will only pi$$ it off ;-)
Do you have any reference for your statement?? Very curious ... and
very interested.
I looked at a 5/05 thread about this and didn't see where you said the
same thing: http://tinyurl.com/nrzuf
TIA,
Neil |
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Neil Brooks
medicine forum Guru
Joined: 24 Mar 2005
Posts: 1148
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| Posted: Thu Jun 22, 2006 6:11 pm Post subject:
Re: Tell me about accomodation after cataract surgery
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On Thu, 22 Jun 2006 17:15:55 GMT, Neil Brooks <neil0502@yahoo.com>
wrote:
| Quote: | On Thu, 22 Jun 2006 17:02:29 GMT, William Stacy <wstacy@obase.net
wrote:
cerebus wrote:
I'm a 33yo male with
OD -3.75, -2.50 @ 115,
OS -4.00, -1.00 @ 120
which have been like that for over 25 years. I'm accustomed to
wearing glasses or soft contacts full time.
Since mid-March of this year, I rapidly developed a cataract in my left
eye which is now quite advanced. I've had a consultation for lens
replacement surgery with a well experienced doctor who presented both IQ
and ReSTOR options for my consideration.
Since I have young, otherwise healthy eyes, I'm uncomfortable with the
prospect of losing the ability to accomodate due to surgery. Is this a
given (is the ciliary muscle severed during the procedure)?
No, but the artificial lens will have no focusing ability, as it will be
a rigid lens. Your ciliary muscle will continue to constrict, but it
will have no effect on the iol shape/power (or little or no effect if it
is a hinged/moveable lens).
So ... Doctor Bill ...
If you said what I think you just said, then you answered my $64,000
question.
The *only* place I found data was in Clyde Oyster's book, "The Human
Eye: Structure and Function" (1999) where he said, in effect, that the
ciliary ennervation never stops in presbyopia; only the accommodation
itself.
Intuitively, even before seeing that, I thought this was right.
Otherwise, something would have to "go dark" and "re-ignite" when
AIOLs were implanted.
My doc *still pushes* for me to get RLE + (preferably monofocal)
IOL's, under the premise that my accommodative mechanism will
eventually give up, thus permanently ending the spasm.
*I* think that--based on my history--giving up is *not in the lexicon
of MY* accommodative system and that putting a brick wall in front of
it will only pi$$ it off ;-)
Do you have any reference for your statement?? Very curious ... and
very interested.
I looked at a 5/05 thread about this and didn't see where you said the
same thing: http://tinyurl.com/nrzuf
TIA,
Neil
|
I found this: seems to lend support to my/your theory:
http://www.pubmedcentral.gov/picrender.fcgi?artid=1353417&blobtype=pdf
OR: http://tinyurl.com/jhvzs |
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Scott Seidman
medicine forum Guru Wannabe
Joined: 04 May 2005
Posts: 235
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| Posted: Thu Jun 22, 2006 6:18 pm Post subject:
Re: Tell me about accomodation after cataract surgery
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Neil Brooks <neil0502@yahoo.com> wrote in
news:kejl92du9usc7dvi1ppggvujl6326cqg51@4ax.com:
| Quote: | On Thu, 22 Jun 2006 17:02:29 GMT, William Stacy <wstacy@obase.net
wrote:
cerebus wrote:
I'm a 33yo male with
OD -3.75, -2.50 @ 115,
OS -4.00, -1.00 @ 120
which have been like that for over 25 years. I'm accustomed to
wearing glasses or soft contacts full time.
Since mid-March of this year, I rapidly developed a cataract in my
left
eye which is now quite advanced. I've had a consultation for lens
replacement surgery with a well experienced doctor who presented both
IQ
and ReSTOR options for my consideration.
Since I have young, otherwise healthy eyes, I'm uncomfortable with the
prospect of losing the ability to accomodate due to surgery. Is this
a
given (is the ciliary muscle severed during the procedure)?
No, but the artificial lens will have no focusing ability, as it will
be
a rigid lens. Your ciliary muscle will continue to constrict, but it
will have no effect on the iol shape/power (or little or no effect if
it
is a hinged/moveable lens).
So ... Doctor Bill ...
If you said what I think you just said, then you answered my $64,000
question.
The *only* place I found data was in Clyde Oyster's book, "The Human
Eye: Structure and Function" (1999) where he said, in effect, that the
ciliary ennervation never stops in presbyopia; only the accommodation
itself.
Intuitively, even before seeing that, I thought this was right.
Otherwise, something would have to "go dark" and "re-ignite" when
AIOLs were implanted.
My doc *still pushes* for me to get RLE + (preferably monofocal)
IOL's, under the premise that my accommodative mechanism will
eventually give up, thus permanently ending the spasm.
*I* think that--based on my history--giving up is *not in the lexicon
of MY* accommodative system and that putting a brick wall in front of
it will only pi$$ it off ;-)
Do you have any reference for your statement?? Very curious ... and
very interested.
I looked at a 5/05 thread about this and didn't see where you said the
same thing: http://tinyurl.com/nrzuf
TIA,
Neil
|
There are two current ideas for presbyopia. One, we all have heard of,
is that the lens loses elasticity. The other, which surprised me, is
that the lens grows too big for the cilliary and zonules to be effective.
--
Scott
Reverse name to reply |
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Neil Brooks
medicine forum Guru
Joined: 24 Mar 2005
Posts: 1148
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| Posted: Thu Jun 22, 2006 6:19 pm Post subject:
Re: Tell me about accomodation after cataract surgery
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On 22 Jun 2006 18:18:15 GMT, Scott Seidman
<namdiesttocs@mindspring.com> wrote:
| Quote: | Neil Brooks <neil0502@yahoo.com> wrote in
news:kejl92du9usc7dvi1ppggvujl6326cqg51@4ax.com:
On Thu, 22 Jun 2006 17:02:29 GMT, William Stacy <wstacy@obase.net
wrote:
cerebus wrote:
I'm a 33yo male with
OD -3.75, -2.50 @ 115,
OS -4.00, -1.00 @ 120
which have been like that for over 25 years. I'm accustomed to
wearing glasses or soft contacts full time.
Since mid-March of this year, I rapidly developed a cataract in my
left
eye which is now quite advanced. I've had a consultation for lens
replacement surgery with a well experienced doctor who presented both
IQ
and ReSTOR options for my consideration.
Since I have young, otherwise healthy eyes, I'm uncomfortable with the
prospect of losing the ability to accomodate due to surgery. Is this
a
given (is the ciliary muscle severed during the procedure)?
No, but the artificial lens will have no focusing ability, as it will
be
a rigid lens. Your ciliary muscle will continue to constrict, but it
will have no effect on the iol shape/power (or little or no effect if
it
is a hinged/moveable lens).
So ... Doctor Bill ...
If you said what I think you just said, then you answered my $64,000
question.
The *only* place I found data was in Clyde Oyster's book, "The Human
Eye: Structure and Function" (1999) where he said, in effect, that the
ciliary ennervation never stops in presbyopia; only the accommodation
itself.
Intuitively, even before seeing that, I thought this was right.
Otherwise, something would have to "go dark" and "re-ignite" when
AIOLs were implanted.
My doc *still pushes* for me to get RLE + (preferably monofocal)
IOL's, under the premise that my accommodative mechanism will
eventually give up, thus permanently ending the spasm.
*I* think that--based on my history--giving up is *not in the lexicon
of MY* accommodative system and that putting a brick wall in front of
it will only pi$$ it off ;-)
Do you have any reference for your statement?? Very curious ... and
very interested.
I looked at a 5/05 thread about this and didn't see where you said the
same thing: http://tinyurl.com/nrzuf
TIA,
Neil
There are two current ideas for presbyopia. One, we all have heard of,
is that the lens loses elasticity. The other, which surprised me, is
that the lens grows too big for the cilliary and zonules to be effective.
|
Thanks, Scott.
Given that, though, NEITHER would seem to imply that the ciliaries
retire, move to Palm Beach, and take up golf, would you agree?? |
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Scott Seidman
medicine forum Guru Wannabe
Joined: 04 May 2005
Posts: 235
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| Posted: Thu Jun 22, 2006 6:23 pm Post subject:
Re: Tell me about accomodation after cataract surgery
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Neil Brooks <neil0502@yahoo.com> wrote in
news:5pnl92diun5r29lstjvsunkvnmep01fkg8@4ax.com:
| Quote: | Given that, though, NEITHER would seem to imply that the ciliaries
retire, move to Palm Beach, and take up golf, would you agree??
|
So far. We'll see if the scleral expansion band trials work or not. Even
if they don't work, we should find out if the ciliaries are still working.
I'd be curious to find out if the accomodation/vergence ratios are adaptive
enough to function accurately. In any case, some is probably better than
none!
--
Scott
Reverse name to reply |
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Neil Brooks
medicine forum Guru
Joined: 24 Mar 2005
Posts: 1148
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| Posted: Thu Jun 22, 2006 6:26 pm Post subject:
Re: Tell me about accomodation after cataract surgery
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On 22 Jun 2006 18:23:27 GMT, Scott Seidman
<namdiesttocs@mindspring.com> wrote:
| Quote: | Neil Brooks <neil0502@yahoo.com> wrote in
news:5pnl92diun5r29lstjvsunkvnmep01fkg8@4ax.com:
Given that, though, NEITHER would seem to imply that the ciliaries
retire, move to Palm Beach, and take up golf, would you agree??
So far. We'll see if the scleral expansion band trials work or not. Even
if they don't work, we should find out if the ciliaries are still working.
I'd be curious to find out if the accomodation/vergence ratios are adaptive
enough to function accurately. In any case, some is probably better than
none!
|
.... which brings up yet another question for me: I'm heading exo-
after a lifetime of eso- and 3 surgeries to correct. Fairly stable
alignment at distant, but only because of accommodative control.
Breaks down to 6-8d of exo.
In either of these theories, do you have a guess as to whether the
accommodative amplitudes--even if they DO NOT result in dioptric
changes of the lens (for either reason)--will still influence vergence
(in my case: maintaining my alignment ... at least a little), or ...
because of these issues of presbyopia ... do you think it's more
likely that the exo- will increase as accommodative amplitudes
decrease?
Thanks! |
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Scott Seidman
medicine forum Guru Wannabe
Joined: 04 May 2005
Posts: 235
|
| Posted: Thu Jun 22, 2006 9:54 pm Post subject:
Re: Tell me about accomodation after cataract surgery
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Neil Brooks <neil0502@yahoo.com> wrote in
news:93ol92hs0q7g1gn2p7tjde9nm5f5t2csi9@4ax.com:
| Quote: | On 22 Jun 2006 18:23:27 GMT, Scott Seidman
namdiesttocs@mindspring.com> wrote:
Neil Brooks <neil0502@yahoo.com> wrote in
news:5pnl92diun5r29lstjvsunkvnmep01fkg8@4ax.com:
Given that, though, NEITHER would seem to imply that the ciliaries
retire, move to Palm Beach, and take up golf, would you agree??
So far. We'll see if the scleral expansion band trials work or not.
Even if they don't work, we should find out if the ciliaries are still
working. I'd be curious to find out if the accomodation/vergence
ratios are adaptive enough to function accurately. In any case, some
is probably better than none!
... which brings up yet another question for me: I'm heading exo-
after a lifetime of eso- and 3 surgeries to correct. Fairly stable
alignment at distant, but only because of accommodative control.
Breaks down to 6-8d of exo.
In either of these theories, do you have a guess as to whether the
accommodative amplitudes--even if they DO NOT result in dioptric
changes of the lens (for either reason)--will still influence vergence
(in my case: maintaining my alignment ... at least a little), or ...
because of these issues of presbyopia ... do you think it's more
likely that the exo- will increase as accommodative amplitudes
decrease?
Thanks!
|
We're well beyond anything I can fake my way through now. I've always
thought of the vergence driving accomodation, and not the other way
around. My guess would be that any change in accomodative tone wouldn't
hurt your vergence.
It's fixation that allows you to maintain alignment. Right around the
time laser surgeries really picked up in popularity, there seemed to be a
spate of surgically corrected strabs developing diplopia, I seem to
recall, as vision was impaired enough to impair the boost fixation could
give to alignment.
--
Scott
Reverse name to reply |
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William Stacy
medicine forum Guru
Joined: 01 May 2005
Posts: 1177
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| Posted: Thu Jun 22, 2006 10:47 pm Post subject:
Re: Tell me about accomodation after cataract surgery
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Neil Brooks wrote:
Pretty heady stuff, and kind of macabre what with getting all those eyes
so fresh and whatnot, but I think the theory really belongs to Helmholtz.
I tend to think classically, and have thought for many years that
accommodation drives convergence. Now I'm not so sure. It may be the
other way around, and it even just might be that it's a 2 way street, so
some of each is working...
w.stacy, o.d. |
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Scott Seidman
medicine forum Guru Wannabe
Joined: 04 May 2005
Posts: 235
|
| Posted: Fri Jun 23, 2006 12:02 am Post subject:
Re: Tell me about accomodation after cataract surgery
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William Stacy <wstacy@obase.net> wrote in
news:x6Fmg.27158$VE1.438@newssvr14.news.prodigy.com:
If you're referring to the equatorial growth of the lens, that's Schachar's
theory
| Quote: | I tend to think classically, and have thought for many years that
accommodation drives convergence. Now I'm not so sure. It may be the
other way around, and it even just might be that it's a 2 way street,
so some of each is working...
w.stacy, o.d.
|
Often things like this work out to "a little of each". If I recall
correctly, though, convergence, which is slower than most eye movements, is
still a faster than accommodation. They might both be under the control of
some "premotor" area, though.
Now, all we need is someone to advocate that pupil size drives both 
--
Scott
Reverse name to reply |
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Neil Brooks
medicine forum Guru
Joined: 24 Mar 2005
Posts: 1148
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| Posted: Fri Jun 23, 2006 1:17 am Post subject:
Re: Tell me about accomodation after cataract surgery
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On Thu, 22 Jun 2006 22:47:57 GMT, William Stacy <wstacy@obase.net>
wrote:
| Quote: | Neil Brooks wrote:
I found this: seems to lend support to my/your theory:
http://www.pubmedcentral.gov/picrender.fcgi?artid=1353417&blobtype=pdf
OR: http://tinyurl.com/jhvzs
Pretty heady stuff, and kind of macabre what with getting all those eyes
so fresh and whatnot, but I think the theory really belongs to Helmholtz.
I tend to think classically, and have thought for many years that
accommodation drives convergence. Now I'm not so sure. It may be the
other way around, and it even just might be that it's a 2 way street, so
some of each is working...
|
But ... in either case ... you're of the opinion (at least) that the
drive for accommodation (ciliary innervation) doesn't cease simply
because of presbyopia?
Again, I'm trying to get as knowledgeable as possible about the
chances that rigid IOLs might induce my accommodative mechanism to
declare an Unconditional Surrender. |
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William Stacy
medicine forum Guru
Joined: 01 May 2005
Posts: 1177
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| Posted: Fri Jun 23, 2006 3:23 am Post subject:
Re: Tell me about accomodation after cataract surgery
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Neil Brooks wrote:
| Quote: |
But ... in either case ... you're of the opinion (at least) that the
drive for accommodation (ciliary innervation) doesn't cease simply
because of presbyopia?
|
I do think it continues, and in fact I think I can "feel" my ciliary
muscle working to focus my iol, which it can't of course. It's an
especially strong sensation when I "cross my eyes", as I did as a child
(and in optometry school). I also think it happens less involuntarily
now, but is very strong when I push it hard.
| Quote: |
Again, I'm trying to get as knowledgeable as possible about the
chances that rigid IOLs might induce my accommodative mechanism to
declare an Unconditional Surrender.
|
I think and hope it will, but there is a psychological component to this
as well. You can force yourself to relax, or not, and your comfort may
depend on how well you can use this force.
Anyway, you have already got my advice. Go for the procedure in one eye
(the worse one first), then decide on the other based on what you learn.
But then I have the comforting bias of a successful outcome, and, as
always, your mileage may vary.
w.stacy, o.d. |
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tkopan1@yahoo.com
medicine forum beginner
Joined: 05 Apr 2006
Posts: 13
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| Posted: Wed Jun 28, 2006 1:41 am Post subject:
Re: Tell me about accomodation after cataract surgery
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Right on both counts. The lenses grow thicker and larger and denser
with time. The newborn has the capacity to focus ~20.00D. By the time
you get to be about 40, the focusing drops to about ~5.00D. When it
drops below that, your arms start getting too short for reading. The
lens gains in size and mass while losing flexibility.
There are several new "focusable" implant lenses availble, Restore
being just one. Placement in the lens sulcus is such that when you
focus, it pushes the lens forward letting you see at near, and when the
muscle relaxes as you look away, the lens moves back for distance...IF
I am thinking of the right lens.
Previous posts are correct in that ou should explre all of your
options. It sounds as though yuo are still young enough to focus the
other eye somewhat.
--Dr. Tom
Scott Seidman wrote:
| Quote: | Neil Brooks <neil0502@yahoo.com> wrote in
news:kejl92du9usc7dvi1ppggvujl6326cqg51@4ax.com:
On Thu, 22 Jun 2006 17:02:29 GMT, William Stacy <wstacy@obase.net
wrote:
cerebus wrote:
I'm a 33yo male with
OD -3.75, -2.50 @ 115,
OS -4.00, -1.00 @ 120
which have been like that for over 25 years. I'm accustomed to
wearing glasses or soft contacts full time.
Since mid-March of this year, I rapidly developed a cataract in my
left
eye which is now quite advanced. I've had a consultation for lens
replacement surgery with a well experienced doctor who presented both
IQ
and ReSTOR options for my consideration.
Since I have young, otherwise healthy eyes, I'm uncomfortable with the
prospect of losing the ability to accomodate due to surgery. Is this
a
given (is the ciliary muscle severed during the procedure)?
No, but the artificial lens will have no focusing ability, as it will
be
a rigid lens. Your ciliary muscle will continue to constrict, but it
will have no effect on the iol shape/power (or little or no effect if
it
is a hinged/moveable lens).
So ... Doctor Bill ...
If you said what I think you just said, then you answered my $64,000
question.
The *only* place I found data was in Clyde Oyster's book, "The Human
Eye: Structure and Function" (1999) where he said, in effect, that the
ciliary ennervation never stops in presbyopia; only the accommodation
itself.
Intuitively, even before seeing that, I thought this was right.
Otherwise, something would have to "go dark" and "re-ignite" when
AIOLs were implanted.
My doc *still pushes* for me to get RLE + (preferably monofocal)
IOL's, under the premise that my accommodative mechanism will
eventually give up, thus permanently ending the spasm.
*I* think that--based on my history--giving up is *not in the lexicon
of MY* accommodative system and that putting a brick wall in front of
it will only pi$$ it off ;-)
Do you have any reference for your statement?? Very curious ... and
very interested.
I looked at a 5/05 thread about this and didn't see where you said the
same thing: http://tinyurl.com/nrzuf
TIA,
Neil
There are two current ideas for presbyopia. One, we all have heard of,
is that the lens loses elasticity. The other, which surprised me, is
that the lens grows too big for the cilliary and zonules to be effective.
--
Scott
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