Physiopathology in accommodation and presbyopia, clinical and surgical approach

Accommodation is a complex of phenomena by which the refracting power of the eye changes for focusing on near vision. Accommodative amplitude declines progressively with increasing age. Until today, this phenomenon called presbyopia was explained by Helmholtz's hypothezis which involves only ciliary muscle. It seems that in accommodation are involved, besides the ciliary muscle, the lens and extraventicular elastic components, biophysical dynamics of the lens capsule, vitreous, iris. According with the role of these factors and theirs pathophysiological implications, new surgical technique has developed to reverse presbyopia in the human eye (Surgical reversal presbyopia, Anterior ciliary sclerotomy) and offers a potential for understanding ocular hypertension and treatment of primary open-angle glaucoma.