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调节机制的演变及一种新假说。

The evolution of mechanism of accommodation and a novel hypothesis.

作者信息

Zhang Guanghong, Wei Qian, Lu Lei, Lin Andy L, Qu Chao

机构信息

School of Medicine, University of Electronic Science and Technology of China, No. 2006, Xiyuan Ave West Hi-Tech Zone, Chengdu, CN611731, China.

Department of Ophthalmology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, No. 2006, Xiyuan Ave West Hi-Tech Zone, Chengdu, CN611731, China.

出版信息

Graefes Arch Clin Exp Ophthalmol. 2023 Nov;261(11):3083-3095. doi: 10.1007/s00417-023-06045-w. Epub 2023 Apr 27.


DOI:10.1007/s00417-023-06045-w
PMID:37103620
Abstract

Myopia and presbyopia are two major optometry problems facing the whole society. The mechanism of accommodation is strongly related to the treatments of myopia and presbyopia. However, the key mechanism of accommodation has puzzled us for over 400 years and is still not clear at present, leading to the stagnation of prevention and treatment of myopia and presbyopia. With the continued development of experimental technologies and equipment, the approaches to elucidate accommodation's intricacies have become more methodological and sophisticated. Fortunately, some significant progress has been made. This article is to review the evolution of the mechanism of accommodation. Helmholtz proposed a classical theory of "zonules relax during accommodation." In contrast, Schachar put forward a theory of "zonules taut during accommodation." Those hypotheses are relatively complete, but either do not fully explain everything about the accommodation mechanism or lack sufficient experimental and clinical evidence to support them. Then, some contentious issues are discussed in detail to find the truth. Finally, we proposed our hypothesis about accommodation based on the anatomy of the accommodative apparatus.

摘要

近视和老花眼是全社会面临的两大主要验光问题。调节机制与近视和老花眼的治疗密切相关。然而,调节的关键机制困扰了我们400多年,目前仍不清楚,导致近视和老花眼的防治停滞不前。随着实验技术和设备的不断发展,阐明调节复杂性的方法变得更加系统和精密。幸运的是,已经取得了一些重大进展。本文旨在综述调节机制的演变。亥姆霍兹提出了“调节时悬韧带松弛”的经典理论。相比之下,沙查尔提出了“调节时悬韧带拉紧”的理论。这些假说相对完整,但要么没有完全解释调节机制的所有方面,要么缺乏足够的实验和临床证据支持。然后,详细讨论了一些有争议的问题以探寻真相。最后,我们基于调节装置的解剖结构提出了关于调节的假说。

相似文献

[1]
The evolution of mechanism of accommodation and a novel hypothesis.

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[2]
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[3]
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[4]
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[5]
Presbyopia in light of accommodation.

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[6]
[Accommodation and presbyopia : part 1: physiology of accommodation and development of presbyopia].

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[7]
[Anatomical, morphological and biomechanical aspects of accommodation].

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[8]
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[9]
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[10]
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引用本文的文献

[1]
Hyperopic Eyes Are Structurally More Dynamic Than Myopic Eyes During Accommodation: An In Vivo Investigation.

Invest Ophthalmol Vis Sci. 2025-6-2

[2]
Assessment of binocular vision and accommodation in myopic children wearing defocus incorporated multiple segments (DIMS) spectacle lenses for 24 months.

J Optom. 2025-5-17

[3]
In Vivo Brillouin Analysis of Lens Nucleus and Cortex in Adult Myopic Eyes and Their Correlation With Accommodation.

Invest Ophthalmol Vis Sci. 2025-4-1

[4]
Changes in the thickness of the crystalline lens components before and after cycloplegia in children with different refractive errors.

J Optom. 2025

[5]
Improvement of Presbyopia, Dry Eye, Intraocular Pressure, and Near Vision Through Cassiae Tea Consumption.

Medicina (Kaunas). 2024-12-29

[6]
Effects of accommodation on geometrical parameters of human lens: A systematic review and meta-analysis.

Heliyon. 2024-4-16

本文引用的文献

[1]
Axial Elongation During Short-Term Accommodation in Myopic and Nonmyopic Children.

Invest Ophthalmol Vis Sci. 2022-3-2

[2]
Zinn's zonule.

Prog Retin Eye Res. 2021-5

[3]
The Ciliary Muscle and Zonules of Zinn Modulate Lens Intracellular Hydrostatic Pressure Through Transient Receptor Potential Vanilloid Channels.

Invest Ophthalmol Vis Sci. 2019-10-1

[4]
Vision and the Nobel Prize.

Arq Bras Oftalmol. 2018-4

[5]
Change in human lens dimensions, lens refractive index distribution and ciliary body ring diameter with accommodation.

Biomed Opt Express. 2018-2-21

[6]
Mechanism of accommodation assessed by change in precisely registered ocular images associated with concurrent change in auto-refraction.

Graefes Arch Clin Exp Ophthalmol. 2018-2

[7]
Image registration reveals central lens thickness minimally increases during accommodation.

Clin Ophthalmol. 2017-9-11

[8]
Influence of Gravity on Ocular Lens Position.

Invest Ophthalmol Vis Sci. 2016-4

[9]
Axial length and choroidal thickness changes accompanying prolonged accommodation in myopes and emmetropes.

Vision Res. 2012-11-1

[10]
Thomas Young's contribution to visual optics: the Bakerian Lecture "on the mechanism of the eye".

J Vis. 2010-10-15

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