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VisAbility™ Micro-Inserts are designed to function by elevating the sclera and lifting the underlying ciliary muscles surrounding the crystalline lens. This increases the space between the crystalline lens and the ciliary muscle (i.e., the circumlental space, or CLS), therefore tightening the zonules that hold the lens in place. With proper tension on the zonules, the ciliary muscles can once again change the shape of the lens, thus potentially restoring accommodation and improving uncorrected near vision.
Accommodation is largely a function of the ability of the ciliary muscles to change the shape of the crystalline lens. However, as we age, the crystalline lens continues growing by an average of 20 microns per year by adding progressive layers of tissue, similar to bark on a tree. Conversely, the globe of the eye remains the same size, and thus the CLS becomes increasingly smaller over time.
The growth in the lens and decrease in the CLS is relatively linear, mirroring the decline in accommodative amplitude observed as humans age. Narrowing of the CLS is believed to contribute to the development of presbyopia, as narrowing crowds the ciliary muscles and decreases the space it can move, which inhibits their ability to affect accommodation.