Femtosecond Laser Restoration of Accommodation

The femtosecond laser has emerged as a revolutionary technology in the field of refractive surgery over the past decade, improving cornea-based procedures such as laser vision correction (eg, flap creation, SMILE) and laser-assisted keratoplasty. More recently, the femtosecond laser has been successfully applied to the crystalline lens to assist in cataract surgery. Presbyopia, which is defined as a gradual loss of accommodation, is believed to be due in large part to an increase in stiffness of the crystalline lens.1 Although different methods have been proposed to overcome the symptoms of presbyopia—such as addition of lenses, monovision, and multifocality—none of these aim to restore true accommodation to presbyopic eyes. With the emergence and success of femtosecond laser technology in ophthalmology, it seemed promising to suggest a noninvasive laser procedure to treat presbyopia by softening the natural presbyopic crystalline lens. Myers and Krueger first proposed this concept of laser lens modulation for accommodation restoration in 1998.2 If it is possible to reverse the gradual age-related loss of accommodation using an efficient, noninvasive laser procedure, this may become a future mainstay for treating presbyopia.