The Relationship between the High-Frequency Component of Accommodative Microfluctuation, Accommodative Lag and Accommodative Amplitude in Presbyopic Eyes

Purpose: To determine the relationship between the high-frequency component of accommodative microfluctuation (HFC) and accommodative lag in presbyopic eyes and how they affect the subjective accommodation power with other ophthalmic factors, such as pupil diameter and corneal multifocality.Methods: Forty subjects (80 eyes) were included in this study, and the non-corrected distance and near visual acuity was measured and then converted to log MAR vision.The addition power for 33 cm near visual work was also measured and the accommodative power was measured by the push-up method.The HFC, accommodative lag and pupil size according to accommodative stimuli (-1.0 to -3.0 D) was measured by Speedy-i Autorefractor (Right Mfg Co., Tokyo).The corneal multifocality and corneal astigmatism was measured by corneal topography (TMS-4; Tomey, Erlangen, Germany).Results: The mean age was 60.0 ± 4.66 years (51-68) and there were 23 male and 17 female subjects (1.35:1).The HFC and pupil size showed no significant change according to accommodation demand, however, the accommodative lag showed a statistically significant increase (p < 0.001 by one-way ANOVA).Accommodative lag (-2.0 D) showed a statistically significant negative correlation with the subjective accommodative power, and the pupil size (0 D) showed a positive correlation with the subjective accommodative power.Conclusions: In presbyopia patients, the objective accommodative lag and initial pupil size showed a statistically significant relationship with subjective accommodative power.On the other hand, HFC, pupil size and corneal multifocality, alone may not be indicators to predict accommodative power, but these are important components to explain the dynamic aspect of accommodation.