Functional visual outcomes 2 years after laser anterior ciliary excision

Session Details

Session Title: Corneal, Scleral and Pharmaceutical Treatment of Presbyopia

Session Date/Time: Monday 09/10/2017 | 16:30-18:00

Paper Time: 17:20

Venue: Meeting Center Room I

First Author: : S.Rowen USA

Co Author(s): :    A. Hipsley   D. Ma   C. Sun              

Abstract Details

Purpose:

To evaluate the visual optical quality and visual outcomes up to 2 years following bilateral Laser Anterior Excision (LaserACE) for restoring dynamic near and intermediate vision.

Setting:

Prospective single arm clinical study, Chang Gung Memorial Hospital, Linkou Taiwan.

Methods:

An Er:YAG laser was used in 4 quadrants on the sclera to improve pliability & biomechanical efficiency of the ciliary muscles in 3 critical zones, for 24 patients. Patients were over 40 years of age and showed loss of accommodative ability. Three patients were evaluated Visual outcomes were assessed using the Early Diabetic Retinopathy Study (EDTRS) logMAR charts at 1, 3, 6, 12, and 24 months for all patients, and after 10 years for 3 patients. Visual outcomes were also assessed using randot stereopsis and a pneumatic tonometer.

Results:

Binocular distance corrected near visual acuity (DCNVA) improved from +0.21 ± 0.17 (logMAR) preoperatively, to +0.11 ± 0.12 (logMAR) at 24 months postoperatively (p=0.00026). Uncorrected near visual acuity (UNVA) improved from +0.20 ± 0.16 (logMAR) preoperatively, to +0.12 ± 0.14 (logMAR) at 24 months postoperatively (p=0.0014). At 24 months postoperatively, there was no statistical change in DCVA or UDVA. Mean stereopsis improved from 75.77” preoperatively to 60” at 24 months postoperatively. Average patient intraocular pressure (IOP) improved from 13.56 ± 3.23 mmHg to 11.74 ± 2.64 mmHg at 24 months postoperatively (p=0.000063).

Conclusions:

LaserACE performed using the VisioLite Er:Yag laser appears to be a safe and effective procedure for restoring range of visual performance. LaserACE provided improvement in near vision functionality in these patients with long-term stability, and without compromising UDVA, CDVA, or binocularity. The LaserACE procedure is not on the visual axis, therefore these patients could still receive correction.

Financial Disclosure:

gains financially from product or procedure presented, receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented