Scleral expansion surgery does not restore accommodation in human presbyopia.

OBJECTIVE: To determine the efficacy of scleral expansion surgery in the treatment of human presbyopia. DESIGN: Experimental study. PARTICIPANTS: Three preoperative presbyopic subjects, three postoperative presbyopic subjects, and three young control subjects. METHODS: Accommodative responses were recorded by an infrared dynamic optometer while subjects viewed an accommodative stimulus that stepped from 0 to 4 diopters in 1-diopter steps. MAIN OUTCOME MEASURES: Dynamic infrared optometer recordings of accommodation. RESULTS: Presbyopic patients showed no evidence of accommodation after scleral expansion surgery. CONCLUSIONS: If presbyopic patients read smaller letters at near after scleral expansion surgery than they were able to read prior to the surgery, then an explanation other than the restoration of accommodation needs to be found.