Accommodative improvements and biomechanical changes in macaque non-human primates after laser scleral microporation

Session Details

Session Title: Vision & Accommodation Assessment

Session Date/Time: Monday 24/09/2018 | 14:00-16:00

Paper Time: 15:06

Venue: Room A3, Podium 2

First Author: : J.Mehta SINGAPORE

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

Abstract Details

Purpose:

To evaluate accommodative and biomechanical changes in macaque non-human primates after the Laser Scleral Microporation (LSM) procedure for presbyopia therapy.

Setting:

Singapore National Eye Centre

Methods:

An Er:YAG laser was used to rejuvenate age-related ocular rigidity in 5 critical zones of anatomical and functional significance. Twelve eyes of six monkeys were treated: Young (<10 years of age N=2) and Old with loss of accommodation (>10 years of age N=4). Ranges of distance and near vision were created using pharmacological stimulation; cycloplegic drops for distance, and pilocarpine drops for near. Ray-tracing aberrometry and double-pass wavefront were used to objectively measure accommodation. Intraocular Pressure (IOP) was assessed using a pneumatic tonometer. Immunochemistry analysis was done with the markers for inflammation, fibrosis, wound healing, and proliferative activity.

Results:

LSM provided improvement in true physiological accommodation, pseudoaccommodation, and effective range of focus. For old monkeys, true accommodation improved by 3 D at 5 months postoperatively, while effective range of focus improved by 4 D. Positive changes after the LSM procedure were also seen in both spherical aberration and depth of focus, which contributed to improvements in pseudoaccommodation. Additionally, average IOP was 13.0 ± 0.8 mmHg preoperatively and significantly improved to 10.1±2.2 mmHg 5 months postoperatively (p=0.0000014). No obvious inflammatory cells or fibrotic reaction was observed. Data collection is ongoing.

Conclusions:

Preliminary results show LSM to be a safe and effective procedure for improving accommodation in non-human primates without touching the visual axis. Positive changes in IOP and overall resting and dynamic spherical aberrations suggest that the posture of the lens may be changed as a result of this treatment. Improved wound healing may affect LSM treatment efficacy and increase the accommodation restoration in presbyopes using a primate model.

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, ... is employed by a for-profit company with an interest in the subject of the presentation