Wydanie 2/2006

Nowe możliwości w leczeniu starczowzroczności

New Methods in Presbyopia Treatment

Justyna Izdebska1,2, Iwona Liberek2,3, Jerzy Szaflik1,2

1 Katedra i Klinika Okulistyki II Wydziału Lekarskiego Akademi Medycznej w Warszawie
Kierownik: prof. dr hab. n. med. Jerzy Szaflik
2 Centrum Mikrochirurgii Oka LASER w Warszawie
Kierownik: prof. dr hab. n. med. Jerzy Szaflik
3 Klinika Okulistyki Centrum Medycznego Kształcenia Podyplomowego w Warszawie
Po. kierownika: dr n. med. Iwona Liberek

Summary: Presbyopia is a condition that affects the vast majority of middle-aged individuals. Conventionally, it is treated by use of additional convex lens spectacles for near work and reading. In last decade many attempts have been made to surgically reverse this condition. Currently there are many techniques for presbyopia treatment directed to people who are 40 to 50 years of age and just becoming presbyopic and noticing the transition. They are the group who would perhaps benefit most from these new methods. Although there are mentioned the conventional ways of presbyopia treatment (glases and contact lenses), the aim of this paper is to present, based on literature and our experience the current status of correcting presbyopia. This article concentrates on surgical methods such as lens extraction and following multifocal or accomodative intraocular lens implantations, termokeratoplasty (especially conductive keratoplasty), multifocal LASIK, sclerectomy with or without scleral implants and LAPR(Laser Presbyopia Reversal). Scleral expansion surgery procedure as the way of treatment of presbyopia received FDA permission in 2004, but it is still controversial because of lack of the theoretical assumptions underlying this technique. LAPR is the newest method of anterior sclerectomy performed using Er:YAG laser. Theories of accommodation, surgical techniques, instruments, treatment criteria, complications and results of clinical study regarding available technologies are briefly discussed in this paper.

Keywords: contact lenses for presbyopia, monovision, mulifocal or accomodative intraocular lens implantations, termokeratoplasty, conductive keratoplasty, multifocal LASIK, sclerectomy, scleral implants, LAPR(Laser Presbyopia Reversal).