Primary Result Of Laser Presbyopia Reversal(LAPR) Surgery And Exploration Of Its Mechanism

Objective: To observe the primary result of laser presbyopia reversal (LAPR)surgery and investigate its mechanism.Methods: (1) Laser presbyopia reversal(LAPR) surgery was performed in 4 presbyopia patients. The changes of the patients' visual acuity, accommodation ability, eye refraction and intraocular pressure (IOP) were observed. (2) 12 rabbits were made the same surgery, one eye with laser, and the other eye with razor blade. The degree of scleral incision inflammation and order of fabric were observed at a day, 3 days, one week, two weeks and two months after operation respectively using hematoxylin and eosin (HE) staining and double combination staining.Results: (1) The operated eyes' near visual acuity and accommodation ability were significantly improved. The average improvement of accommodation was 1.8D at the time of 1 year after surgery. The other eye of each patient also had a slight improvement in near sight and accommodation, but soon reversed after 3 months. The far visual acuity had slight changes in near time after the surgery, but had no apparent change in the long ran. The changes of the eye refraction were mainly showed in sphere and cylinder transform during the early three months of the surgery. The IOP was slightly decreased in a month after the surgery. There were no complications observed. (2) The degrees of the sclera incision inflammation in laser eyes were significantly lower than those in razor blade eyes. The order of fabric was also better in laser eyes. The laser incision was healed with subconjunctival tissue.Conclusions: Laser presbyopia reversal (LAPR) was an safe and effective method for presbyopia. The mechanism of the surgery was strengthening the ciliary muscle by increasing the sclera elasticity and expanding the ciliary ring space. The laser incision had the properties of retard healing, relatively ordered fabric and less granulation .That were also the reasons of less reverse rate of the surgery.