A longitudinal study of accommodative changes in biometry during incipient presbyopia

Deborah S. Laughton, Amy L. Sheppard, Leon N. Davies

Research output: Contribution to journalArticle

Abstract

PURPOSE: To profile accommodative biometric changes longitudinally and to determine the influence of age-related ocular structural changes on the accommodative response prior to the onset of presbyopia.

METHODS: Twenty participants (aged 34-41 years) were reviewed at six-monthly intervals over two and a half years. At each visit, ocular biometry was measured with the LenStar biometer (www.Haag-Streit.com) in response to 0.00, 3.00 and 4.50 D stimuli. Accommodative responses were measured by the WAM 5500 Auto Ref/Keratometer (www.grandseiko.com).

RESULTS: During accommodation, anterior chamber depth reduced (F = 29, p < 0.001), whereas crystalline lens thickness (F = 39, p < 0.001) and axial length (F = 5.4, p = 0.009) increased. The accommodative response (F = 5.5, p = 0.001) and the change in anterior chamber depth (F = 3.1, p = 0.039), crystalline lens thickness (F = 3.0, p = 0.042) and axial length (F = 2.5, p = 0.038) in response to the 4.50 D accommodative target reduced after 2.5 years. However, the change in anterior chamber depth (F = 2.2, p = 0.097), crystalline lens thickness (F = 1.7, p = 0.18) and axial length (F = 1.0, p = 0.40) per dioptre of accommodation exerted remained invariant after 2.5 years. The increase in disaccommodated crystalline lens thickness with age was not significantly associated with the reduction in accommodative response (R = 0.32, p = 0.17).

CONCLUSION: Despite significant age-related structural changes in disaccommodated biometry, the change in biometry per dioptre of accommodation exerted remained invariant with age. The present study supports the Helmholtz theory of accommodation and suggests an increase in lenticular stiffness is primarily responsible for the onset of presbyopia.

Original languageEnglish
Pages (from-to)33–42
Number of pages10
JournalOphthalmic and Physiological Optics
Volume36
Issue number1
Early online date2 Oct 2015
DOIs
Publication statusPublished - Jan 2016

Bibliographical note

This is the peer reviewed version of the following article: Laughton, D. S., Sheppard, A. L., & Davies, L. N. (2015). A longitudinal study of accommodative changes in biometry during incipient presbyopia. Ophthalmic and physiological optics, Early view. which has been published in final form at http://dx.doi.org/10.1111/opo.12242. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.

Funding: College of Optometrists Postgraduate Research Scholarship

Keywords

  • accommodation
  • biometry
  • crystalline lens
  • presbyopia

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