Posters

Ray tracing wavefront analysis of accommodative ability after laser anterior ciliary excision in progressively aging presbyopes

Poster Details

First Author: K. Maia Rocha UNITED STATES

Co Author(s):    A. Hipsley                    

Abstract Details

Purpose:

Our purpose was to evaluate the long-term visual outcomes after bilateral Laser Anterior Ciliary Excision (LaserACE) procedure to assess the accommodative ability in presbyopes. We evaluated serial measurements of higher-order aberrations and depth of focus using ray-tracing aberrometry in post laser vision correction (LVC) patients who also underwent Laser Anterior LaserACE procedure for accommodation restoration.

Setting:

Retrospective Study Department of Ophthalmology Medical University South Carolina Charleston South Carolina

Methods:

LaserACE was performed with a 2.94um Er:Yag to create 9 micro-excisions on the sclera of the eye. In this study the long term outcomes of, 3 patients (6 eyes) who underwent bilateral LaserACE are evaluated. All patients had laser vision correction (LVC) surgery with hyperopic regression prior to LaserACE.. Visual parameters measured were: uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected near visual acuity (UNDVA) and distance corrected near visual acuity (CDNVA) respectively. Wavefront analysis was performed using Ray-tracing aberrometer. Long-term visual functionality data is presented from 1 month up to 12 years after LaserACE.

Results:

Mean post-operative age was 58.33 ±1.1 (range: 58 to 59 yrs). Last mean follow-up was10 yrs ±0.49 (range: 8 to 12 yrs). Visual acuity and ray-tracing aberrometry were analyzed. The UDVA range: OD (20/15 to 20/25) ;OS (20/20 to 20/40). The CDVA range: OD:(20/15 to 20/20) ; OS (20/15 to 20/20). The UNVA range: OD(20/20 to 20/40); OS(20/20 to 20/30). The CNVA range: OD(20/15 to 20/20); OS(20/15 to 20/20). All patients had both sphere and HOA changes desirable for near vision functionality with distance correction in place. LaserACE showed a positive effect on modular transfer function (MTF) of the internal optics.

Conclusions:

Ray-tracing technology can objectively measure dynamic accommodation as well as specific lens behavior. Positive changes after LaserACE procedure were seen in both spherical aberration and depth of focus. Pseudoaccommodation from changes in spherical aberration and increased depth of focus may contribute to near vision functionality. LaserACE appears to provide improvement in near vision functionality in these LVC patients with long-term stability. Since the LaserACE procedure is not on the visual axis these patients are still able to get enhancements in their LVC correction to plano allowing them to utilizing the accommodative capacity restored an average of 10 years postoperatively.

Financial Disclosure:

One or more of the authors research is funded, fully or partially, by a company producing, developing or supplying the product or procedure presented