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The evolution of mechanism of accommodation and a novel hypothesis

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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.

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Funding

This review was funded by the Natural Science Foundation of China (no. 82171026).

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Authors and Affiliations

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

    Guanghong Zhang & Chao Qu

  2. 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

    Guanghong Zhang & Chao Qu

  3. Sichuan Key Laboratory for Disease Gene Study, Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, No. 32 of the West 2nd Section of First Ring Road, Chengdu, 610072, China

    Guanghong Zhang & Chao Qu

  4. Southwest Medical University, No. 319, Section 3, Zhongshan Road, Luzhou, 646000, China

    Qian Wei

  5. School and Hospital of Stomatology, Wenzhou Medical University, Xueyuan West Road, Wenzhou, Zhejiang, 325027, China

    Lei Lu

  6. Department of Internal Medicine, UC Irvine Medical Center, 333 City Blvd. West, Suite 400, Orange, CA, 92868-3298, USA

    Andy L. Lin

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Guanghong Zhang had the idea for the article and drafted the manuscript; Qian Wei retrieved and ranked documents; Andy L. Lin and Lei Lu provided critical revision of the manuscript; Chao Qu provided supervisory support. All authors read and approved the final manuscript.

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Zhang, G., Wei, Q., Lu, L. et al. The evolution of mechanism of accommodation and a novel hypothesis. Graefes Arch Clin Exp Ophthalmol 261, 3083–3095 (2023). https://doi.org/10.1007/s00417-023-06045-w

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