24 month dynamic range of visual outcomes after laser anterior ciliary excision (LaserACE) procedure

Session Details

Session Title: Corneal and Scleral Treatment

Session Date/Time: Wednesday 09/09/2015 | 08:00-09:30

Paper Time: 09:18

Venue: Room 13

First Author: : D.Ma TAIWAN

Co Author(s): :    A. Hipsley   C. Sun   M. Jackson              

Abstract Details

Purpose:

To evaluate accommodative benefits for dynamic range of vision at near (40 cm) and intermediate (60cm) visual performance after Laser Anterior Ciliary Excision (LaserACE) procedure.

Setting:

Chang Gung Memorial Hospital (Linkou, Taiwan) registered single arm clinical trial.

Methods:

This prospective clinical trial evaluated the LaserACE procedure results over 24 months. 18 subjects over 40 years of age demonstrating loss of accommodative function, good uncorrected distant vision with less than 1.0 D of refractive astigmatism, and otherwise healthy eyes were evaluated. LaserACE was performed using a 2.94 um Er:Yag laser in four quadrants on the sclera over the ciliary muscle in 3 key zones to decrease ocular rigidity to improve biomechanical accommodative forces. Primary study targets were improvement in UIVA/DCIVA (60 cm) and UNVA/DCNVA (40 cm) and UDVA/CDVA.

Results:

All patients achieved improved near/intermediate vision. Pearson Correlation statistical analysis was performed. Postoperatively, DCIVA was 20/30 or better in 100% of subjects; 89% were 20/25 and 78% were 20/20 (p = 0.176) DCNVA was 20/30 or better in 83% of subjects; 67% were 20/25 and 50% were 20/20 (p = 0.007).Postoperatively, UIVA was 20/30 or better in 89% of subjects; 72% were 20/25 and 72% were 20/20(p = 0.305), UNVA was 20/30 or better in 83% of subjects; 78% were 20/25 and 33% were 20/20 (p = 0.046). No statistical change was noted in DCVA/UDVA. Stereopsis improved from 75.77” to 60” which was clinically significant.

Conclusions:

LaserACE performed using the VisioLite Er:Yag laser appears to be a safe and effective procedure for restoring range of visual performance for near and intermediate visual tasks without compromising UDVA/CDVA or binocularity. Stereopsis was not only preserved but improved over time.Patient satisfaction was high post-operatively, and was sustained over the 24 months.

Financial Interest:

One of the authors gains financially from product or procedure presented, One of the authors research is funded, fully or partially, by a company producing, developing or supplying the product or procedure presented, One of the authors has significant investment interest in a company producing, developing or supplying product or procedure presented