THE ETIOLOGY OF PRESBYOPIA - A SUMMARY OF THE ROLE OF LENTICULAR AND EXTRALENTICULAR STRUCTURES
THE ETIOLOGY OF PRESBYOPIA - A SUMMARY OF THE ROLE OF LENTICULAR AND EXTRALENTICULAR STRUCTURES
复制标题
DOI：
10.1016/0275-5408(95)00095-u
复制
发表时间：
1995-09-01
影响因子：
2.9
通讯作者：
GILMARTIN, B
中科院分区：
文献类型：
--
作者：
GILMARTIN, B
老花眼是年龄而不是衰老的一种情况，因此，从可悲的情况下，正常的年龄相关的调节幅度下降达到一个点，即近距离的视觉清晰度不能维持足够长的时间来满足个人的要求。我们的大部分设施在55岁时已经丧失，随后近视眼的视觉表现恶化是由于验光师熟悉的老化视力的特征。因此，我们对老花眼原因的理解主要是从我们对年轻眼睛调节机制的理解中得出的。赫尔曼·冯·赫姆霍尔茨在阐明这些机制方面做了很多工作，但尽管在他去世后的100年里进行了许多研究，但对于它们的确切性质仍然没有达成共识。本文对调节生理学和老花眼的文献进行了总结，证实老花眼的病理生理学可能是由于一些相互关联的组织的结构和功能的恶化所致。然而，晶状体大小随年龄的变化、晶状体带附着物几何形状的变化以及晶状体囊和晶状体基质的粘弹性特性的变化似乎是老花眼发病的主要相关因素。最新的调节生物力学模型已经引起了人们对晶状体外作用于老花眼的可行性的关注，并研究了后部、前部和张力性纤维系统提供的弹性和杠杆的特性。在矫正和矫正老花眼方面，创新的刺激是强大的，因为工业化国家至少98%的人可以活到45岁；值得注意的是，100年前的存活率只有60%。
Presbyopia is a condition of age rather than ageing and, as such, is devolved from the lamentable situation where the normal age-related reduction in amplitude of accommodation reaches a point when the clarity of vision at near cannot be sustained for long enough to satisfy an individual's requirements. Most of our facility to accommodate has been lost by 55 years-of-age and subsequent deterioration in visual performance at near is attributable to characteristics of senescent vision familiar to the optometrist. Our understanding of the cause of presbyopia has then to be derived principally from our understanding of the mechanism of accommodation in young eyes. Hermann von Helmholtz did much to clarify these mechanisms, but despite much research in the 100 years since his death, there is still no consensus on their precise nature. This paper presents a summary of issues, past and present, which have figured in the literature on the physiology of accommodation and presbyopia, and confirms that the pathophysiology of presbyopia is likely to result from deterioration in structure and function of a number of inter-related tissues. Changes in crystalline lens dimensions with age, the associated change in geometry of zonular attachments, and changes in viscoelastic properties of the lens capsule and lens matrix would, however, appear to be the principal correlates for the onset of presbyopia. Recent models of the biomechanics of accommodation have drawn attention to the feasibility of extralenticular contributions to presbyopia and have examined properties of the elasticity and leverage provided by posterior, anterior and tensile fibre systems. The stimulus for innovation in the correction and remediation of presbyopia is strong as at least 98% of individuals from the industrialised nations will survive until 45 years-of-age; it is salutary to note that the survival rate 100 years ago was only 60%.