Eyeglass correction: influence on the morphometric parameters of the anterior chamber and the eye hydrodynamics in presbyopes with hyperopia

The work of accommodative apparatus has a regulatory effect on the hydrodynamics of eye and it is involved in ensuring the normal outflow of intraocular fluid (IOF). Age-related weakening of accommodation leads to a deterioration in the state of hydrodynamics, and especially significant shifts are expected in patients with axial hyperopia in the anatomical boundaries of “short” eye.

Purpose. To evaluate the effect of correction with progressive lenses and monofocal ones on hydrodynamic indicators and certain morphometric parameters of the anterior chamber in presbyopic patients with hyperopia under conditions of long-term habitual professional eye strain.

Material and methods. 25 subjects (50 eyes) of 44–55 y. o. (mean age 47 ± 1,6 years) were examined in January-July 2022. There were 8 males and 17 females with presbyopia and hyperopia. All patients were examined at the end of their working day: the first examination was performed in the initial state without correction, the second one − under using correction with monofocal lenses (control group) or progressive ones (main group). The examination methods included visometry, autorefractometry, pneumotonometry, ultrasound biometry, computerized tonography, determination of accommodation amplitude using the push-up test, optical coherence tomography of the eye anterior segment.

Results. The critic tension of hydrodynamics, the decreasing of anterior chamber depth and iridocorneal angle width were revealed in presbyopic hyperopic patients under the conditions of eye strain at a near distance without correction with eyeglasses. Using of correction with progressive lenses led to significant increasing of the accommodation amplitude (p < 0,001), decreasing of IOP (p < 0,001), increasing of aqueous humor outflow (p < 0,001), deepening of the anterior chamber (p < 0,001) and increasing of the iridocorneal angle width (p < 0,001) compared to the initial state. No significant changes in these parameters were revealed in the users of monofocal lenses compared to the initial state.

Conclusion. Using of progressive lenses as a permanent correction has a positive effect on ocular hydrodynamics and morphometric parameters of the anterior chamber in presbyopic hyperopes. Lack of correction in hyperopic patients of presbyopic age not only causes of eye fatigue but also can lead to disruption of hydrodynamic balance and development of glaucoma.

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