Optimisation of analysis of scleral micropores in presbyopes after laser scleral microporation using ocular coherence tomography (OCT)

Session Details

Session Title: Corneal Presbyopia & Astigmatism Correction

Session Date/Time: Tuesday 17/09/2019 | 16:30-18:00

Paper Time: 17:14

Venue: Free Paper Forum: Podium 3

First Author: : S.Rowen USA

Co Author(s): :    A. Hipsley   J. Mehta   Y. Liu   B. Hall                    

Abstract Details

Purpose:

To evaluated and characterize treatment depth along with effects of in presbyopes during Laser Scleral Microporation (LSM) using optical coherence tomography.

Setting:

Animal Study performed at the Singapore National Eye Centre, 11 Third Hospital Ave, Singapore 168751

Methods:

Six non-human primates (n = 12 eyes) at presbyopic age underwent LSM. The LSM treatment utilized a 2.94um Erbium Yttrium Aluminum Garnet (Er:YAG) laser in 4 oblique quadrants on the sclera to rejuvenate age-related ocular rigidity reduce biomechanical stiffness, and improve efficiency of the ciliary muscles in 5 critical zones of anatomical and functional significance. Slit lamp, anterior segment optical coherence tomography (ASOCT), intraocular pressure (IOP) measurements, and accommodation were performed postoperatively. Wound healing profiles were also characterized at 1, 6, and 9 months postoperatively and examined for stability.

Results:

On ASOCT evaluation, the margin of the micropores was clearly visible. The mean laser ablation depth was 81.2 ± 5.8% at 1 month postoperatively, which decreased to 72.7 ± 11.5% at 6 months postoperatively. Average preoperative IOP of 13.0 ± 0.8 mmHg was significantly reduced to an average of 10.2±0.8mmHg postoperatively and was sustained through 7 months postoperatively (p=0.000076). At 7 months postoperatively, EROF was increased by approximately 8D on average, which corresponded to a 5D increase in true accommodation and a 3D increase in pseudoaccommodation. At 9 months, there was minimal scleral fibroblast migration into the micropores.

Conclusions:

OCT is a useful tool in characterization of scleral micropores for depth, pore quality, pore density and evaluation of microporation patterns. LSM at approximately 80% depth of the sclera appears to not only improve accommodative ability, but also to reduce IOP. Wound healing profiles demonstrated in this study showed rejuvenated scleral tissue to remain stable over time.

Financial Disclosure:

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