Study implicates lenticular sclerotic component in presbyopia

This prospective interventional case series of 23 eyes of 15 subjects demonstrated that centripetal movement of the ciliary body induced with 2% pilocarpine hydrochloride (OcuCarpine, Samil Pharm. Co., Ltd., Seoul, Korea) significantly improved after cataract extraction. The study's results implicated a lenticular sclerotic component as the cause of decreased accommodation with aging. However, other causes, such as changes in the relationship of the capsular bag equator to the ciliary body or geometric changes in the ciliary body following cataract extraction, could not be ruled out as contributory factors for the apparent increase in ciliary body movement following cataract extraction.

The study's authors used ultrasound bimocroscopy (UBM) to measure the contractility of the ciliary muscle in presbyopic eyes before and 30 minutes after instilling pilocarpine both before and after cataract surgery. The surgery involved phacoemulsification and aspiration through a clear corneal incision, followed by implantation of an AcrySof SA60AT foldable IOL (Alcon Laboratories Inc., Fort Worth, Texas).

UBM performed before cataract extraction after instillation of pilocarpine revealed only subtle movement of the ciliary body, which was not significantly different from the results obtained before pilocarpine administration. But pilocarpine instillation induced significant ciliary body movement, as measured with UBM, after cataract surgery.

Financial Disclosures
Dr. Hoffman has no financial interests to disclose.