Age-related changes in centripetal ciliary body movement relative to centripetal lens movement in monkeys

The goal was to determine the age-related changes in accommodative movements of the lens and ciliary body in rhesus monkeys. Varying levels of accommodation were stimulated via the Edinger-Westphal (E-W) nucleus in 26 rhesus monkeys, aged 6–27 years, and the refractive changes were measured by coincidence refractometry. Centripetal ciliary process (CP) and lens movements were measured by computerized image analysis of goniovideographic images. Ultrasound biomicroscopy (UBM) at 50 MHz was used to visualize and measure accommodative forward movements of the ciliary body in relation to age, accommodative amplitude, and centripetal CP and lens movements. At ～3 diopters of accommodation, the amount of centripetal lens movement required did not significantly change with age (p = 0.10; n = 18 monkeys); however, the amount of centripetal CP movement required significantly increased with age (p = 0.01; n = 18 monkeys), while the amount of forward ciliary body movement significantly decreased with age (p = 0.007; n = 11 monkeys). In the middle-aged animals (12–16.5 years), a greater amount of centripetal CP movement was required to induce a given level of lens movement and thereby a given level of accommodation (p = 0.01), compared to the young animals (6–10 yrs). Collectively, the data suggests that, with age, the accommodative system may be attempting to compensate for the loss of forward ciliary body movement by increasing the amount of centripetal CP movement. This, in turn, would allow enough zonular relaxation to achieve the magnitude of centripetal lens movement necessary for a given amplitude of accommodation.     

Age-related changes in centripetal ciliary body movement relative to centripetal lens movement in monkeys

The goal was to determine the age-related changes in accommodative movements of the lens and ciliary body in rhesus monkeys. Varying levels of accommodation were stimulated via the Edinger-Westphal (E-W) nucleus in 26 rhesus monkeys, aged 6–27 years, and the refractive changes were measured by coincidence refractometry. Centripetal ciliary process (CP) and lens movements were measured by computerized image analysis of goniovideographic images. Ultrasound biomicroscopy (UBM) at 50 MHz was used to visualize and measure accommodative forward movements of the ciliary body in relation to age, accommodative amplitude, and centripetal CP and lens movements. At ∼3 diopters of accommodation, the amount of centripetal lens movement required did not significantly change with age (p = 0.10; n = 18 monkeys); however, the amount of centripetal CP movement required significantly increased with age (p = 0.01; n = 18 monkeys), while the amount of forward ciliary body movement significantly decreased with age (p = 0.007; n = 11 monkeys). In the middle-aged animals (12–16.5 years), a greater amount of centripetal CP movement was required to induce a given level of lens movement and thereby a given level of accommodation (p = 0.01), compared to the young animals (6–10 yrs). Collectively, the data suggests that, with age, the accommodative system may be attempting to compensate for the loss of forward ciliary body movement by increasing the amount of centripetal CP movement. This, in turn, would allow enough zonular relaxation to achieve the magnitude of centripetal lens movement necessary for a given amplitude of accommodation.     

Edinger-Westphal and pharmacologically stimulated accommodative refractive changes and lens and ciliary process movements in rhesus monkeys

During accommodation, the refractive changes occur when the ciliary muscle contracts, releasing resting zonular tension and allowing the lens capsule to mold the lens into an accommodated form. This results in centripetal movement of the ciliary processes and lens edge. The goal of this study was to understand the relationship between accommodative refractive changes, ciliary process movements and lens edge movements during Edinger-Westphal (EW) and pharmacologically stimulated accommodation in adolescent rhesus monkeys. Experiments were performed on one eye each of three rhesus monkeys with permanent indwelling electrodes in the EW nucleus of the midbrain. EW stimulated accommodative refractive changes were measured with infrared photorefraction, and ciliary process and lens edge movements were measured with slit-lamp goniovideography on the temporal aspect of the eye. Images were recorded on the nasal aspect for one eye during EW stimulation. Image analysis was performed off-line at 30 Hz to determine refractive changes and ciliary body and lens edge movements during EW stimulated accommodation and after carbachol iontophoresis to determine drug induced accommodative movements. Maximum EW stimulated accommodation was 7.36+/-0.49 D and pharmacologically stimulated accommodation was 14.44+/-1.21 D. During EW stimulated accommodation, the ciliary processes and lens edge moved centripetally linearly by 0.030+/-0.001 mm/D and 0.027+/-0.001 mm/D, with a total movement of 0.219+/-0.034 mm and 0.189+/-0.023 mm, respectively. There was no significant nasal/temporal difference in ciliary process or lens edge movements. 30-40 min after pharmacologically stimulated accommodation, the ciliary processes moved centripetally a total of 0.411+/-0.048 mm, or 0.030+/-0.005 mm/D, and the lens edge moved centripetally 0.258+/-0.014 mm, or 0.019+/-0.003 mm/D. The peaks and valleys of the ciliary processes moved by similar amounts during both supramaximal EW and pharmacologically stimulated accommodation. In conclusion, this study shows, for the first time, that the ciliary processes and lens edge move centripetally, linearly with refraction during EW stimulated accommodation. During pharmacological stimulation, the ciliary processes move to a greater extent than the lens edge, confirming that in adolescent monkeys, lens movement limits the accommodative optical change in the eye.     

Accommodative changes in lens diameter in rhesus monkeys

PURPOSE: Some debate surrounds the accommodative mechanism in primates, particularly whether the lens equatorial diameter increases or decreases during accommodation. This study has been undertaken to measure the relationship between changes in lens diameter and refraction during accommodation in rhesus monkeys. METHODS: Photorefraction was used to measure accommodation, and goniovideography was used to measure accommodative changes in lens diameter in the iridectomized eyes of two rhesus monkeys. Accommodation was stimulated through the full amplitude available to each eye by stimulation of the Edinger-Westphal nucleus of the brain. Dynamic measurement of refractive changes followed by dynamic measurements of changes in lens diameter for the same stimulus current amplitudes allow the relationship between refraction and lens diameter to be determined. RESULTS: Lens diameter decreased relatively linearly during accommodation by 0.055 mm/diopter (D), resulting in an overall decrease in lens diameter of approximately 7% of the unaccommodated lens diameter for approximately 12 D of accommodation. CONCLUSIONS: The rhesus monkey lens diameter decreases systematically with the refractive change during accommodation in accordance with the Helmholtz accommodative mechanism and in contrast to the accommodative mechanism originally proposed by Tscherning.     

The effects of phenylephrine on pupil diameter and accommodation in rhesus monkeys

PURPOSE: Phenylephrine is used to dilate the iris through alpha-adrenergic stimulation of the iris dilator muscle. Sympathetic stimulation of the ciliary muscle is believed to be inhibitory, decreasing accommodative amplitude. Investigations in humans have suggested some loss of functional accommodation after phenylephrine. It is unclear whether this loss is due to direct action of phenylephrine on the ciliary muscle or to secondary optical factors associated with mydriasis. The purpose of this study was to determine whether phenylephrine affects Edinger-Westphal (EW)-stimulated accommodation in rhesus monkeys. METHODS: The time course for maximum mydriasis was determined by videographic pupillography after phenylephrine instillation in 10 normal rhesus monkeys. Static and dynamic EW-stimulated accommodative responses were studied in five iridectomized rhesus monkeys before and after phenylephrine instillation. Accommodative amplitude was measured with a Hartinger coincidence refractometer. Dynamic accommodative responses were measured with infrared photorefraction, and functions were fitted to the data to determine peak velocity versus accommodative response relationships. RESULTS: The maximum dilated pupil diameter of 8.39 +/- 0.23 mm occurred 15 minutes after administration of phenylephrine. In iridectomized monkeys, postphenylephrine accommodative amplitudes were similar to prephenylephrine amplitudes. Dynamic analysis of the accommodative responses showed linear peak velocity versus accommodative amplitude relationships that were not statistically different before and after phenylephrine. CONCLUSIONS: alpha-Adrenergic stimulation causes a strong pupil dilation in noniridectomized monkey eyes but does not affect EW-stimulated accommodative amplitude or dynamics in anesthetized, iridectomized rhesus monkeys.     

The role of the iris in accommodation of rhesus monkeys

After unilateral total iridectomy, maximum accommodation inducible by corneal iontophoresis of carbachol in rhesus monkeys was approximately 40% less in the iridectomized than in the contralateral untouched eyes, irrespective of age. Ultrasonographically measured anterior chamber shallowing and lens thickening were also less in the iridectomized eyes. Neither submaximal accommodation induced by intramuscular pilocarpine infusion nor maximum accommodation inducible by midbrain stimulation differed in iridectomized and intact eyes. The authors hypothesize that at maximum cholinomimetic drug-induced contraction, the iris sphincter muscle pulls the ciliary body farther forward and inward than does maximum ciliary muscle contraction alone, allowing additional rounding of the lens and, consequently, additional accommodative power.     

The zonula, lens, and circumlental space in the normal iridectomized rhesus monkey eye

PURPOSE: To document zonular orientation and suspension of the lens during accommodation, and age-related changes of the circumlental space (CLS) at rest and during accommodation, in living iridectomized rhesus monkey eyes. METHODS: The CLS was measured in 34 iridectomized eyes of 24 living rhesus monkeys, age 5.7 to 26 years, in the resting and accommodated state, and the orientation of the zonula and suspension of the lens during accommodation was assessed qualitatively. RESULTS: The nonaccommodated CLS decreased significantly with age in both the nasal and temporal quadrants and tended to do so at a slightly faster rate in the temporal quadrant. The CLS correlated significantly with the accommodative amplitude: the greater the CLS the greater the accommodative amplitude. Multiple regression analysis indicated that age and CLS together are better predictors of accommodative amplitude than is age alone. The zonula appeared taut in the nonaccommodated eye throughout the age range despite the age-related decline in CLS. CONCLUSIONS: Characterization of age-related changes in the accommodative apparatus may help to model the system for hypothesis testing. The CLS may be an indicator of presbyopia-related processes in surrounding tissues. However, these results do not prove that the width of the CLS, in and of itself, has a causal relationship with accommodative amplitude, or that changes in the CLS play a pathophysiological role in presbyopia.     

睫状肌收缩与可折叠人工晶状体植入眼伪调节力的关系

目的分析和探讨可折叠人工晶状体（IOL）植入眼睫状肌收缩功能与伪调节力的关系。方法超声乳化白内障吸除及囊袋内可折叠IOL植入术后3个月,采用红外验光仪中调节性微波动分析软件检测瞳孔直径2．0—3．5mm、对光反应良好的50例患者（50只眼）的睫状肌调节性微波动高频成分（HFC）,并与患者术眼的伪调节力、IOL移动度等因素进行相关分析。结果HFC与IOL移动度呈正相关（r=0．702,P〈0．01）,IOL移动度与伪调节力呈正相关（r=0．861,P〈0．01）,HFC与伪调节力呈正相关（r=0．915,P〈0．01）。即IOL植入术后睫状肌的收缩能力越强,则IOL移动度越大,术后伪调节力越强。结论可折叠IOL植入术后术眼的睫状肌收缩可能导致IOL移动,这可能是IOL眼伪调节力增大的重要原因之一。     

The effect of cataract extraction on the contractility of ciliary muscle

PURPOSE: To evaluate the changes in the pilocarpine-induced contractility of the ciliary muscle in eyes with presbyopia before and after cataract extraction using ultrasound biomicroscopy (UBM). DESIGN: Prospective interventional case series. METHODS: A clear corneal phacoemulsification and posterior chamber intraocular lens (AcrySof SA60AT; Alcon Laboratories, Fort Worth, Texas, USA) was implanted in 23 eyes in 15 subjects. UBM was performed with and without instilling 2% pilocarpine, as well as before and two months after cataract extraction. The mean (+/- standard deviation) age was 65.33 +/- 6.09 years (range, 56 to 75 years). The increase in the axial length of the ciliary body (CBAXL) was used as a surrogate indicator of the centripetal ciliary muscle contraction during accommodation. Images of the ciliary body were compared visually using Adobe Photoshop 7.0 (Adobe Systems Inc., San Jose, California, USA). RESULTS: The CBAXL value with and without pilocarpine before cataract extraction was 1.708 +/- 0.165 mm and 1.689 +/- 0.187 mm, respectively, which was not significantly different (P = .261). The CBAXL value with and without pilocarpine after cataract extraction was 1.998 +/- 0.375 mm and 1.675 +/- 0.279 mm, respectively, which was significantly different (P < .001). The visually compared configurations of the changes in the ciliary body were compatible with the analysis of the measured parameters. CONCLUSIONS: Pilocarpine induced only subtle movement of the ciliary body before cataract surgery. However, after cataract extraction, it induced significant centripetal movement of the ciliary body compared with that without pilocarpine. This shows that a lenticular sclerotic component may influence both lens movement and the contractility of the ciliary muscle, and is believed to be related to the presbyopia.     

Lens diameter and thickness as a function of age and pharmacologically stimulated accommodation in rhesus monkeys

Uncertainty exists regarding accommodative and age changes in lens diameter and thickness in humans and monkeys. In this study, unaccommodated and accommodated refraction, lens diameter, and lens thickness were measured in rhesus monkeys across a range of ages. Iridectomized eyes were studied in 33 anesthetized monkeys aged 4-23 years. Refraction was measured using a Hartinger coincidence refractometer and lens thickness was measured with A-scan ultrasound. Lens diameters were measured with image analysis from slit-lamp images captured via a video camera while a saline filled, plano perfusion lens was placed on the cornea. Accommodation was pharmacologically stimulated with 2% pilocarpine via the perfusion lens in 21 of the monkeys and lens diameters were measured until a stable minimum was achieved. Refraction and lens thickness were measured again after the eye was accommodated. Unaccommodated lens thickness increased linearly with age by 0.029 mm/year while unaccommodated lens diameter showed no systematic change with age. Accommodative amplitude decreased by 0.462 D/year in response to pilocarpine. The accommodative increase in lens thickness decreased with age by 0.022 mm/year. The accommodative decrease in lens diameter declined linearly with age by 0.021 mm/year. Rhesus monkeys undergo the expected presbyopic changes including increasing lens thickness and a decreasing ability of the lens to undergo changes in thickness and diameter with accommodation, however without an age-related change in unaccommodated lens diameter. As in humans, the age-related decrease in accommodative amplitude in rhesus monkeys cannot be attributed to an age-related increase in lens diameter.     

Optomechanical response of human and monkey lenses in a lens stretcher

PURPOSE: To quantify the forces necessary to change the shape and optical power of human and monkey lenses. METHODS: Cynomolgus monkey (n = 48; age: 3.8-11 years), rhesus monkey (n = 35; age: 0.7-17 years) and human (n = 20, age 8-70 years) eyes obtained postmortem, including the lens, capsule, zonules, ciliary body, and sclera were mounted in an optomechanical lens-stretching system. Starting at zero load, the lenses were symmetrically stretched in a stepwise fashion in 0.25- or 0.5-mm steps. The load, lens diameter, inner ciliary body diameter, and lens power were measured at each step and the diameter- and power-load responses were quantified. RESULTS: The diameter- and power-load responses were found to be linear in the physiologically relevant range of stretching. The average change in cynomolgus, rhesus, and human lens diameter, respectively, was 0.094, 0.109, and 0.069 mm/g in young lenses, and 0.069, 0.067, and 0.036, mm/g in older lenses. For the same lenses, the average change in lens power was -3.73, -2.83, and -1.22 D/g in young lenses and -2.46, -2.16, and -0.49 D/g in older lenses. CONCLUSIONS: The force necessary to change the lens diameter and lens power increases with age in human and monkey lenses. The results agree with the Helmholtz theory of accommodation and with presbyopia theories that predict that the force required to disaccommodate the lens increases with age.     

Accommodative lens refilling in rhesus monkeys

PURPOSE: Accommodation can be restored to presbyopic human eyes by refilling the capsular bag with a soft polymer. This study was conducted to test whether accommodation, measurable as changes in optical refraction, can be restored with a newly developed refilling polymer in a rhesus monkey model. A specific intra- and postoperative treatment protocol was used to minimize postoperative inflammation and to delay capsular opacification. METHODS: Nine adolescent rhesus monkeys underwent refilling of the lens capsular bag with a polymer. In the first four monkeys (group A) the surgical procedure was followed by two weekly subconjunctival injections of corticosteroids. In a second group of five monkeys (group B) a treatment intended to delay the development of capsular opacification was applied during the surgery, and, in the postoperative period, eye drops and two subconjunctival injections of corticosteroids were applied. Accommodation was stimulated with carbachol iontophoresis or pilocarpine and was measured with a Hartinger refractometer at regular times during a follow-up period of 37 weeks in five monkeys. In one monkey, lens thickness changes were measured with A-scan ultrasound. RESULTS: In group A, refraction measurement was possible in one monkey. In the three other animals in group A, postoperative inflammation and capsular opacification prevented refraction measurements. In group B, the maximum accommodative amplitude of the surgically treated eyes was 6.3 D. In three monkeys the accommodative amplitude decreased to almost 0 D after 37 weeks. In the two other monkeys, the accommodative amplitude remained stable at +/-4 D during the follow-up period. In group B, capsular opacification developed in the postoperative period, but refraction measurements could still be performed during the whole follow-up period of 37 weeks. CONCLUSIONS: A certain level of accommodation can be restored after lens refilling in adolescent rhesus monkeys. During the follow-up period refraction measurements were possible in all five monkeys that underwent the treatment designed to prevent inflammation and capsular opacification.     

Magnetic resonance imaging of aging, accommodating, phakic, and pseudophakic ciliary muscle diameters

PURPOSE: To quantify in vivo accommodative changes in the aging human ciliary muscle diameter in phakic and pseudophakic eyes. SETTING: Department of Surgery/Bioengineering, UMDNJ-Robert Wood Johnson Medical School, Piscataway, and the Institute of Ophthalmology and Visual Science UMDNJ-New Jersey Medical School, Newark, New Jersey, USA. METHODS: Images were acquired from 48 eyes of 40 people between the ages of 22 and 91 years, 1 eye of 32 phakic volunteers and both eyes of 8 patients who had monocular implantation of a single-piece AcrySof intraocular lens (IOL) (Alcon Laboratories). Images were acquired during physiological accommodation and with accommodation at rest, and the diameter of the ciliary muscle ring was measured. RESULTS: Results show the ciliary muscle remains active throughout life. The accommodative change in its diameter (mean 0.64 mm) (P<.00001) was undiminished by age or IOL implantation. Preliminary data showed that the accommodative decrease in muscle diameter in phakic and pseudophakic eyes was statistically identical. The phakic eyes had a marked decrease in ciliary muscle diameter with advancing age for both accommodative states (P<.000001 and P<.000001), which did not appear to be altered by IOL implantation. The lens equator was constant with age in the unaccommodated human eye, resulting in decreased circumlental space with advancing age in the phakic eyes. CONCLUSION: Although the undiminished ability of the ciliary muscle to decrease its diameter with accommodation can be relied on in strategies for presbyopia correction, even in advanced presbyopia, the decreasing circumlental space and its potential effects on zonular tension must also be considered.     

Anterior movement of the crystalline lens in the process of accommodation in children

PURPOSE: To investigate changes of crystalline lens position during accommodation in children with emmetropia, myopia, and hyperopia. METHODS: A total of 188 children (372 eyes) from 4 to 19 years old (mean age 11.3+/-4.43) with cycloplegic refractive error within a range +9.00 D to -9.00 D were enrolled. After a general ophthalmic examination, ultrasound biometry was performed, with the eye at a maximal accommodative effort. Cycloplegia was induced by triple installation of 1% tropicamide drops and 30 minutes later the biometric examination was repeated. RESULTS: In emmetropic eyes in the process of accommodation, the anterior pole of the crystalline lens moved forward by 0.144+/-0.14 mm (p< or =0.001); the position of the posterior pole did not change. In myopic eyes, the anterior pole moved forward by 0.071+/-0.13 mm (p< or = 0.001) and the posterior pole moved backward by 0.039+/-0.10 mm (p=0.003). In hyperopic eyes, the whole lens translocated anteriorly: anterior pole moved forward by 0.242+/-0.16 mm (p< or = 0.001) and posterior pole moved forward by 0.036+/-0.09 mm (p< or = 0.001). Differences among emmetropia, myopia, and hyperopia were statistically significant. Forward movement of the posterior pole correlated with a low axial length of the eye, and also with plus refractive error and with a smaller accommodative increase of lens thickness. CONCLUSIONS: In children, accommodative changes of the crystalline lens position depend on refractive status.     

Comparisons between pharmacologically and Edinger-Westphal-stimulated accommodation in rhesus monkeys

PURPOSE: Accommodation results in increased lens thickness and lens surface curvatures. Previous studies suggest that lens biometric accommodative changes are different with pharmacological and voluntary accommodation. In this study, refractive and biometric changes during Edinger-Westphal (EW) and pharmacologically stimulated accommodation in rhesus monkeys were compared. METHODS: Accommodation was stimulated by an indwelling permanent electrode in the EW nucleus of the midbrain in one eye each of four rhesus monkeys. Dynamic refractive changes were measured with infrared photorefraction, and lens biometric changes were measured with high-resolution, continuous A-scan ultrasonography for increasing stimulus current amplitudes, including supramaximal current amplitudes. Accommodation was then stimulated pharmacologically and biometry was measured continuously for 30 minutes. RESULTS: During EW-stimulated accommodation, lens surfaces move linearly with refraction, with an increase in lens thickness of 0.06 mm/D, an anterior movement of the anterior lens surface of 0.04 mm/D, and a posterior movement of the posterior lens surface of 0.02 mm/D. Peak velocity of accommodation (diopters per second) and lens thickness (in millimeters per second) increased with supramaximal stimulus currents, but without further increase in amplitude or total lens thickness. After carbachol stimulation, there was initially an anterior movement of the anterior lens surface and a posterior movement of the posterior lens surface; but by 30 minutes, there was an overall anterior shift of the lens. CONCLUSIONS: Ocular biometric changes differ with EW and pharmacological stimulation of accommodation. Pharmacological stimulation results in a greater increase in lens thickness, an overall forward movement of the lens and a greater change in dioptric power.     

Intraocular lens movement caused by ciliary muscle contraction

PURPOSE: To investigate intraocular lens (IOL) movement, measured as a change in anterior chamber depth (ACD) caused by pilocarpine-induced ciliary muscle contraction. SETTING: Department of Ophthalmology, University of Vienna, Vienna, Austria. METHODS: In this prospective study, the ACD was measured using high-precision, high-resolution, dual-beam partial coherence interferometry in 62 pseudophakic eyes of 55 patients under pilocarpine- and cyclopentolate-induced ciliary muscle contraction and relaxation. The following were studied: 2 models of a ring-haptic IOL (designed to accommodate), a plate-haptic IOL, and 3 types of 3-piece IOLs. Measurements were performed 3 months after surgery. RESULTS: The ring-haptic IOLs and plate-haptic IOL showed a forward movement (ring haptic 43A, -116 microm; ring haptic 43E, -222 microm; plate haptic -162 microm). The 3-piece IOLs showed no change in ACD except in 1 IOL type in which there was backward movement (156 microm). CONCLUSIONS: Pilocarpine-induced ciliary muscle contraction caused forward movement of ring- and plate-haptic IOLs that resulted in an estimated accommodative amplitude of less than 0.50 diopter in most cases. The accommodating ring-haptic IOLs did not perform better than the conventional plate-haptic IOL.     

Pseudophakic accommodation with translation lenses – dual optic vs mono optic

PURPOSE: To investigate the pseudophakic accommodation effect in dual and mono optic translation accommodative intraocular lenses (AIOL) using linear matrix methods in the paraxial space. METHODS: Dual (anterior optic of power +32 D linked to a compensatory posterior optic of negative power) and mono lens power was determined in the non-accommodated state using linear geometric optics based on the Gullstrand model eye. The position of the AIOL was calculated from a regression formula. Pseudophakic accommodation was assessed with three systems: (1) forward shift of the mono optic lens, (2) anterior translation of the anterior optic in the dual optic lens system with an unchanged position of the posterior minus lens and (3) symmetrical anterior and posterior translation of the anterior and posterior lens. The Gullstrand model eye was modified by changing the axial length (and proportionally changing the phakic anterior chamber depth) to investigate the accommodative effect in myopic and hyperopic eyes. RESULTS: The dual optic lens system (2) yields a nearly constant accommodation amplitude of 2.4-2.5 D mm(-1) movement over the total range of axial lengths. The mono optic lens (1) provides a higher accommodative effect only in extremely short eyes (high refractive power of the lens), whereas for normal eyes (1.4-1.5 D mm(-1) movement) and for long (myopic) eyes the accommodative effect is much less than the dual optic lens. The dual optic lens system under condition (3) yields less accommodation amplitude compared with the dual optic system under condition (2) over the total range of axial length but provides higher accommodation amplitude compared with the mono optic lens system (1) with axial lengths greater than 22.3 mm (lens power 25.5 D). In the accommodated state, with lens translation of 1 mm, the absolute value of the lateral magnification increases with the refractive power of the mono optic lens (1) and decreases in both dual optic lens systems (under conditions 2 and 3). CONCLUSIONS: A mathematical strategy is presented for calculation of the accommodative effect of mono-optic and dual optic AIOL. The dual optic lens yielded a nearly constant accommodation amplitude of about 2.4-2.5 D mm(-1) translation, whereas the mono optic lens yielded an accommodative response of <2 D mm(-1) translation in long myopic or normal eyes. Only in extremely short eyes is the accommodative amplitude of the mono-optic lens higher than the dual optic lens.     

Age-related changes in human ciliary muscle and lens: a magnetic resonance imaging study

PURPOSE: To use high-resolution magnetic resonance (MR) images of the eye to directly measure the relationship between ciliary muscle contraction and lens response with advancing age. METHODS: A General Electric, 1.5-Tesla MR imager and a custom-designed eye imaging coil were used to collect high-resolution MR images from 25 subjects, 22 through 83 years of age. A nonmagnetic binocular stimulus apparatus was used to induce both relaxed accommodation (0.1 diopter [D]) and strong accommodative effort (8.0 D). Measurements of the ciliary muscle ring diameter (based on the inner apex), lens equatorial diameter, and lens thickness were derived from the MR images. RESULTS: Muscle contraction is present in all subjects and reduces only slightly with advancing age. A decrease in the diameter of the unaccommodated ciliary muscle ring was highly correlated with advancing age. Lens equatorial diameter does not correlate with age for either accommodative state. Although unaccommodated lens thickness (i.e., lens minor axis length) increases with age, the thickness of the lens under accommodative effort is only modestly age-dependent. CONCLUSIONS: Ciliary muscle contractile activity remains active in all subjects. A decrease in the unaccommodated ciliary muscle diameter, along with the previously noted increase in lens thickness (the "lens paradox"), demonstrates the greatest correlation with advancing age. These results support the theory that presbyopia is actually the loss in ability to disaccommodate due to increases in lens thickness, the inward movement of the ciliary ring, or both.     

Dynamic accommodative changes in rhesus monkey eyes assessed with A-scan ultrasound biometry.

PURPOSE: Prior studies in humans measured time constants of biometric accommodative changes as a function of amplitude, and prior studies in monkeys used slit lamp videography to analyze dynamic lenticular accommodative movements. Neither of these studies related biometric changes to refractive changes. We wished to develop and test methodology to begin to test the hypothesis that ocular biometric changes are well correlated with accommodative refractive changes in rhesus monkeys. METHODS: Methodology is described to dynamically measure biometric accommodative changes with A-scan ultrasonography. Lens thickness, anterior chamber depth, and anterior segment length (anterior chamber depth plus lens thickness) were measured dynamically during Edinger-Westphal-stimulated accommodation in two eyes of one rhesus monkey. In addition, dynamic accommodative refractive changes were measured with infrared photorefraction. Functions were fit to the accommodative and disaccommodative responses to obtain time constants. Derivatives of these functions allow peak velocities to be determined for each amplitude. Dynamic changes in lens thickness and anterior chamber depth measured with A-scan biometry were compared with dynamic measures of accommodation using infrared photorefraction. RESULTS: Lens thickness and anterior segment length increase and anterior chamber depth decreases during accommodation. The biometric changes are well correlated with the accommodative optical changes. Peak velocities of accommodative changes in lens thickness and anterior chamber depth increase with amplitude and peak velocities for disaccommodation were higher than those for accommodation. CONCLUSIONS: Dynamic A-scan provides a method for dynamic analysis of the accommodative biometric changes during Edinger-Westphal-stimulated accommodation in monkeys, although the measurement resolution of this approach is limited.     

Edinger--Westphal stimulated accommodative dynamics in anesthetized, middle-aged rhesus monkeys

The relationships between peak velocity and amplitude of Edinger-Westphal (EW) stimulated accommodation and disaccommodation were investigated in anesthetized, middle-aged rhesus monkeys. Accommodative responses were recorded at 30Hz with infrared photorefraction. Peak velocity of accommodation and disaccommodation increased linearly with stimulus amplitude. Peak velocities of accommodation continued to increase with stimulus amplitudes greater than required to produce the maximum response. The peak velocity of disaccommodation did not further increase with supramaximal stimulus amplitudes beyond that achieved with maximal stimulus amplitudes. Although maximum accommodative response amplitude is reduced in older rhesus monkeys, within the methodological constraints of this study, older monkeys appear to achieve accommodative and disaccommodative peak velocities similar to adolescent monkeys for the same response amplitudes.