Small-Aperture Strategies for the Correction of Presbyopia

Authors and Disclosures

H. Burkhard Dick

Center for Vision Science, University Eye Hospital, Bochum, Germany

Correspondence to
H. Burkhard Dick, MD, PhD, FEBOS-CR, Center for Vision Science, University Eye Hospital, In der Schornau 23–25, Bochum, Germany. Tel: +49 234 299 83152; e-mail: burkhard.dick@kk-bochum.de

Conflicts of interest
The author is Consultant to AcuFocus.

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Key Points

• Channeling light through a small aperture – whether artificial, induced, or natural – blocks incident stray light and unfocused peripheral light, extending the depth of field and minimizing the impact of corneal aberrations on vision.

• Six months after implantation with a small-aperture posterior chamber IOL in one eye, 99, 95, and 79% of patients achieved 20/32 or better binocular UDVA, UIVA, and UNVA, respectively.

• Safety and efficacy of a small-aperture corneal inlay for presbyopia correction has been well documented, including both objective and subjective, patientreported outcomes.

• Newer formulations of topical drops aimed at presbyopia treatment use a combination of agents to achieve a small pupil while reducing unwanted side effects.

• Perceived brightness is greater than what would be expected from theoretical calculations based on aperture size, and this effect is likely due to neuroadaptation.