Moderator
James Katz, MD
Panelists
Mayank A. Nanavaty, PhD
Ehud I. Assia, MD
Viewing Papers
Expand a paper title to the right to view the paper abstract and authors. Use the video link to jump to that poster in the session.
Presenting Author
Ori Stern, MD
Co-Authors
Liat Mendel MD, Olga Reitblat MHA, MD, Adi Levy MHA, BSc, Oren Gabbay MD, Ehud Assia MD, Guy Kleinmann MD
Purpose
To compare patients' results and satisfaction with presbyopia correcting intra-ocular lens (IOL) after the second eye operation versus the first eye operation.
Methods
A retrospective cohort study of patients who underwent uneventful bilateral cataract surgery with Multifocal (MF) and Extended depth of focus (EDOF) IOL between 2017-2024. One month after surgery, complete ophthalmic examination was performed, including visual acuity and refraction. A self-reported satisfaction questionnaire was filled out.
Results
One-hundred patients underwent bilateral IOL implantation (47 EDOF, 53 MF). For both groups, no difference was found in the uncorrected visual acuity results for the first compared with the second eye (p>0.05). In the MF group, there was a statistically significant improvement in patients� perception of their uncorrected vision for intermediate (p=0.034) and near (p=0.018), and spectacle independence for all ranges (p=0.01 for far; p=0.002 for intermediate; p=0.015 for near vision). For the EDOF IOL group, a statistically significant improvement was found in the spectacle independence for far (p=0.018) and intermediate (p=0.003) vision after the second cataract surgery.
Conclusion
Although there was no improvement in the objective visual outcomes, patient satisfaction after presbyopia-correcting IOL implantation significantly improved after the second eye surgery with better spectacle independence. Patients unsatisfied after surgery of the first eye may be reassured of expected improvement after the fellow eye surgery.
Presenting Author
Faruk Semiz, MD
Co-Authors
Ceren Ece Semiz MD, Njomza H MD, Fetih Furkan Arslan MD
Purpose
The objective of this study is to explore the efficacy of treating both distance and near visual acuity by modifying the corneal shape (Q value) through the implantation of a myopic lenticule using the SMILE (Small Incision Lenticule Extraction) technique. This approach aims to address the challenges associated with hyperopia and presbyopia.
Methods
A total of 30 patients (40 eyes) participated in this study. The participants were aged between 20 and 50 years, with a minimum corneal thickness of 450 ?m and a maximum of 550 ?m. The lenticule implantation was performed using allogenic implants sourced from myopic patients with refractive errors ranging from -4.0 D to -6.50 D. These lenticules were implanted into hyperopic patients with refractive errors ranging from +4.0 D to +6.50 D and astigmatism between +0.75 D and +1.75 D, utilizing the SMILE (Small Incision Lenticule Extraction) module according to corneal topography. The patients were followed for an average duration of one year. ClinicalTrials.gov Identifier: NCT04616144.
Results
The Q value decreased from ?0.50 � 0.04 log MAR preoperatively to ?0.78 � 0.05 log MAR one year postoperatively (p<0.001). uncorrected="" near="" visual="" acuity="" (unva)="" at="" 35="" cm="" improved="" from="" j7="" preoperatively="" to="" j2="" postoperatively,="" and="" unva="" at="" 70="" cm="" improved="" from="" j6="" preoperatively="" to="" j3="">
Conclusion
This method effectively treats distance, intermediate, and near vision by reshaping the cornea. It is safe and effective for hyperopia and presbyopia patients without cataracts and with corneal thickness below 550 ?m.
Presenting Author
Nishi M. Satish, MBBS, MS
Co-Authors
Ritu Singh MS, DNB, Harinder Sethi MD, FRCS, DNB, Sangeeta Abrol MS, MBA, MPH
Purpose
Our study is aimed to analyse the efficacy and safety profile of 1% Pilocarpine nitrate eyedrop in presbyopia management.
Methods
Design: The current project was a tertiary care hospital based, prospective, interventional study conducted for a duration of three months. Methods: Phakic patients aged >40 years, with or without use of glasses for distance were recruited. Exclusion criteria were uveitis, history of ocular surgery, concomitant systemic morbidity, known allergy to concerned drug, media opacity. The patients were prescribed the eyedrop once a day and were followed up monthly for repeat evaluation of near vision and onset of any adverse effects.
Results
153 patients were recruited in study after meeting inclusion criteria, with a mean age of 46 � 4.03 years. The gender distribution was almost equal. Majority of patients were homemakers (31.4%; n=48), followed by working professionals such as software engineers, desk job professionals, tailors, security guards, drivers, paramedical staff, teachers. Paired t tests were performed to study near visual acuity at 2 weeks and 1 month.There was significant reduction in refraction after 2 weeks(p=0.0001). The patients complained of minimal side effects like- hyperemia (n=20) and brow ache (n=34). One individual had developed cataractous changes; however, the age of the individual was 59 years.
Conclusion
The analysis found that use of topical 1% Pilocarpine nitrate aided in better near visual acuity with no serious side effects. However, limitations of the study were smaller sample size and shorter follow- up period.
Presenting Author
Abdelrahman M. Elhusseiny, MD
Co-Authors
Muhammad Chauhan MS, MD, Ahmed Sallam FRCOphth, MD, PhD, Sayena Jabbehdari MD, MPH, Nayef Alshammari MD, MS, Sarah Jong BA, Paul Phillips MD
Purpose
To examine the association between topical pilocarpine and the risk of new-onset rhegmatogenous retinal detachment (RRD).
Methods
A retrospective clinical database study of aggregated electronic health records. We examined the risk of first-time RRD (ICD-10: H33.0x) following initiation of pilocarpine at any dose. The primary study group included adult patients over 40 years with the diagnosis of presbyopia, open-angle glaucoma, or chronic angle-closure glaucoma who received pilocarpine for the first time. Our control group consisted of patients who were started on artificial tears and had no history of topical pilocarpine use during the study period. We matched both cohorts using propensity score matching.
Results
After matching, 3-month risk of first-time RRD was significantly higher in the study group (0.20%) compared to the control (0.11%) (HR: 5.81, 95% CI: 1.71-19.73). The 6-month risk was also higher at 0.29% in the study group and 0.11% in the control group (HR: 5.16, 95% CI: 1.99-13.46). At one year, the risk was 0.52% and 0.12%, respectively (HR: 4.09, 95% CI: 2.12-7.87). In myopic patients, the one-year risk of RRD in the study and control groups was 0.46% and 0.13%, respectively (HR: 3.27, 95% CI, 1.43-7.46). For patients with a history of lattice degeneration or retinal break, the one-year risk in the study and control groups was 3.89% and 1.18%, respectively (HR: 1.78, 95% CI, 0.52-6.09).
Conclusion
Our study quantified the increased risk of RRD associated with topical pilocarpine use. The risk did not differ with various drug concentrations.
Presenting Author
Daniel C. Terveen, MD
Co-Authors
Emily Schehlein MD, Tanner Ferguson MD, Jada Tschetter BSc
Purpose
To demonstrate the impact of a virtual reality (VR) educational tool on advanced technology intraocular lens (AT-IOL) adoption in patients undergoing cataract surgery.
Methods
Retrospective, multi-center study of patients undergoing cataract surgery. Five practices instituted a pilot program to evaluate the VR Technology. Patients undergoing cataract surgery eligible for AT-IOL�s were offered the educational experience. Rate of AT-IOL adoption and type of AT-IOL were recorded for the patients that underwent the experience. The overall AT-IOL adoption rate for the practice during the pilot was recorded and compared to the adoption rates for the proceeding 6 months. Following completion of the cataract surgery in the patients that underwent the VR experience, a phone survey was completed evaluating the patient�s satisfaction with the IOL choice and VR experience.
Results
There were 289 patients that underwent the VR educational tool across 5 sites. The patients in the VR group chose an AT-IOL 54.7% of the time vs 26% in the control group (P-value<0.0001). of="" those="" that="" chose="" an="" at-iol="" in="" the="" vr="" group="" 54%="" chose="" multifocal,="" 23%="" lal,="" 17%="" toric="" and="" 6%="" edof.="" at="" 3="" months="" post-op="" 86%="" of="" the="" vr="" group="" said="" their="" current="" vision="" resembled="" the="" vision="" in="" the="" vr="" headset.="" the="" vr="" group="" was="" asked="" about="" their="" experience="" with="" the="" headset="" and="" 83.6%="" said="" it="" was="" easy="" or="" very="" easy="" to="" use,="" 79.5%="" said="" it="" was="" helpful="" in="" understanding="" lens="" options,="" 82%="" probably="" or="" definitely="" would="" use="" the="" headset="" again="" and="" 91%="" probably="" or="" definitely="" would="" recommend="" vr="" education="" to="" their="">
Conclusion
Our study found that the VR educational tool increased AT-IOL adoption across 5 sites in a retrospective case control study. In addition, patients found the VR headset to be useful and realistic in helping to educate on IOL options prior to cataract surgery.
Presenting Author
Ronald R. Krueger, MD, MSE
Co-Authors
Satish Herekar MS
Purpose
Previous attempts at restoring accommodation with lens-based femtosecond lasers and disulfide bond breaking drops have largely been unsuccessful. Our study aims to investigate micro-shock waves, as a new ocular energy source, to mitigate effects of age-related stiffening of the sclera and lens, thereby restoring accommodation in presbyopic eyes.
Methods
A specialized, electro-hydraulic shock wave emitter was designed for precise delivery to the sclera and lens. Initial testing was conducted on multiple porcine eyes to evaluate the therapeutic effects under varying conditions. Subsequently, a focused subset of 12 porcine eyes underwent high energy, collimated shock wave therapy applied directly to the sclera and dissected lens. Both wave propagation ocular coherence elastography (OCE) and Brillouin scatter elastography were used to measure changes in elastic modulus pre- and post-treatment. Additionally, lens clarity was assessed using USAF target images.
Results
Shock wave therapy was shown to induce ocular tissue effects in ocular tissues, including disaggregation, cavitation and softening, which collectively reduce scleral and lens stiffening. Shock wave energies of 2 KV, delivered at 500-5000 Hz for 30-120 seconds were found to enhance tissue compliance in both sclera and lens. OCE measurements indicated a statistically significant reduction in the elastic modulus by 11-12% in both sclera and lens (p<0.001) while="" brillouin="" scatter="" data="" revealed="" a="" modest="" 4%="" reduction="" in="" frequency="" shift="" in="" the="" lens.="" noteably,="" lens="" clarity="" improved="" post-treatment,="" with="" observed="" volume="" reduction,="" leading="" to="" capsular="" wrinkling="" under="" excessive="" treatment="">
Conclusion
Micro-shock wave therapy emerges as a promising, minimally invasive technique capable of restoring accommodation by improving the compliance of the sclera and lens. Further studies on aging human cadaver eyes are warranted to further these findings and to advance preclinical testing and early clinical trials.
Presenting Author
Robert Edward T. Ang, MD
Purpose
The refractive and visual outcomes of the presbyopic laser algorithm SUPRACOR with two different ablation profiles (strong and regular) using the TECHNOLAS TENEO 317 Model 2 Excimer Laser Platform were evaluated in this prospective, 12-month, randomized, single-surgeon study (NCT04617080).
Methods
Sixty patients with presbyopia (36 myopic, 24 hyperopic) were treated bilaterally, with the dominant eye treated using the aspheric ablation profile PROSCAN, and the non-dominant eye randomized (1:1) to either SUPRACOR strong or SUPRACOR regular ablation profile with a refractive target of ?0.50D. The primary outcome was binocular uncorrected (U) distance (D) visual acuity (VA) at 3 months. Secondary and other outcomes included manifest refraction spherical equivalent (MRSE), monocular and binocular VA at all distances (U, corrected [C], D, intermediate [I], and near [N]), defocus curve, contrast sensitivity, and patient-reported outcomes measures at 3 months and 12 months of follow up.
Results
At 1-year post surgery, mean logMAR � standard deviation (SD) binocular UDVA was ?0.01�0.04 (regular) and 0.00�0.05 (strong); UIVA was 0.00�0.06 (regular) and 0.00�0.08 (strong); UNVA was 0.09�0.10 (regular) and 0.10�0.12 (strong); and CDVA was ?0.01�0.03 (regular) and ?0.01�0.04 (strong). Mean MRSE � SD improved from ?1.54�3.13D preoperatively to ?0.57�0.47D post-operatively (regular), and from ?2.84�2.81D to ?0.71�0.56D (strong). No statistically significant differences were observed between groups. Binocular defocus curve reported useful VA (?0.2 logMAR) up to ?2.5D, and patient-reported questionnaires showed high spectacle independence for both groups.
Conclusion
Both SUPRACOR ablation profiles demonstrated restoration of VA at distance, intermediate and near distances, with the refractive target met. Patients treated with SUPRACOR regular or strong in the non-dominant eye and PROSCAN in the dominant eye achieved a high level of VA over the full range of distances.
Presenting Author
Smita Agarwal, FRANZCO, MS, MBBS
Co-Authors
Erin Thornell PhD, Dakota Williams BSc, MSc
Purpose
To assess the functional visual outcomes of PresbyLASIK using the presbyMAX platform.
Methods
Monocular presbyLASIK was performed on a total of 318 eyes from 160 patients with dominant eye targeted for distance (plano) and the non-dominant eye targeted for near (-1.5 to -1.75D). Outcomes were measured at 4-6 weeks following surgery and included uncorrected distance (UDVA) and intermediate (UIVA) visual acuity, manifest refraction and best corrected distance visual acuity (BCVA), contrast sensitivity and stereopsis. Postoperative spherical aberration (SA) and near visual function was assessed using the NAVQ questionnaire for a subset of 35 patients.
Results
Average postoperative spherical equivalent was -0.02�0.37D and -1.12�0.66D for distance and near eyes respectively, with 96% and 58% achieving within �1.0D of target. Average postoperative UDVA was 0.01�0.10 and 0.34�0.20 LogMAR for distance and near eyes respectively with 84% and 17% achieving 0.1 LogMAR or better. Average binocular UIVA was 0.36�0.14 LogMAR (N6-8) with 74% achieving N8 or better. Average contrast sensitivity was 1.36�0.14 and 1.43�0.23 secarc for distance and near eyes respectively. Average binocular stereopsis was 194.3�203.7. Near eyes had significantly more negative SA (P<0.01), but there was no correlation with UDVA or UIVA (P>0.05). Average NAVQ and satisfaction scores were 19.1�0.23 and 1.59�1.18 respectively.
Conclusion
Patient satisfaction was high following presbyLASIK using the presbyMAX platform, with a high proportion of patients achieving excellent distance and good functional intermediate vision. While changes in SA may play a role in improving intermediate vision, further studies may confirm this.
Presenting Author
Itzel P. Aguilar-Valdez, MD
Co-Authors
Ned D�vila-�vila MD, Enrique De La Torre-Gonz�lez MSc, Rosa Alvarado-Villacorta MD, Valeria Sanchez Huerta FACS, MD, Jesus Alejandro Toledo Mart�nez MD
Purpose
Evaluate the optical quality, visual outcomes, and refractive results following excimer laser ablation using non-linear aspheric micro-monovision for presbyopia correction. We aimed to evaluate visual quality assessment due to its relationship with patient satisfaction and quality of life.
Methods
This prospective cohort study included myopic, hyperopic, and emmetropic presbyopic patients eligible for Presbyond� surgery from 2021 to 2024. All patients underwent bilateral Femto-LASIK using VISUMAX� and a non-linear aspheric micro-monovision ablation profile (MEL-90� Carl Zeiss). Patients were categorized into three groups based on their refractive errors, with emmetropic defined as having a spherical equivalent refraction ?-0.88 D with 20/20 uncorrected distance visual acuity (UDVA), manifest sphere ?1.5 D, and manifest cylinder ?-1.25 D. Outcomes assessed included refractive and visual results, higher-order aberrations, optical quality, safety, and patient satisfaction over two years.
Results
38 patients were included. Regarding refractive data, 98% and 96% of the eyes treated were within �1.00 D of achieved spherical equivalent and defocus equivalent, respectively. Binocularly, 99% of patients achieved an uncorrected visual acuity of 20/25 or better for distance, and 91% uncorrected near vision of 20/25 or better, while 76% had a UIVA of 20/32 or better at 12 months of follow-up. Related to high order aberrations, there was a significant change in the postoperative spherical aberration compared to the preoperative values in the emmetropia and hyperopia groups in both eyes. Regarding patients' satisfaction 75% reported being completely satisfied. Our rate of retreatment was 3.6%.
Conclusion
This study showed a good performance in visual outcomes with satisfactory optical quality, safety, and predictability, also we observed the beneficial impact of the modification of the spherical aberrations in emmetropic and hyperopic patients.
Presenting Author
AnnMarie Hipsley, PhD
Co-Authors
Robert Edward Ang MD, Laurent Sabatier MSc, Edwin Price PhD
Purpose
To demonstrate a Digital Twin for the human eye to predict presbyopia outcomes for different stages of presbyopia following Laser Scleral Microporation (LSM) therapy. To determine the effect of stage on Reading ADD.
Methods
A 3D Digital Twin (DT) of the human eye was developed using a Finite Element Model (FEM) incorporating published human data and individual patient ages. The DT model was used to assess the dosage algorithm developed to deliver progressively larger doses of LSM from Stage I to Stage V of presbyopia ranging from 38 years old to 65 years old. Twelve eyes of 6 patients underwent virtual simulations of LSM to recover Dynamic Range of Focus (DRoF). Data from an IRB registered Pilot study is analyzed based on reading ADD measured on subjects from stages III, IV, and V in the presbyopia life cycle before and after LSM. Predictive analysis for Micropore(MP) retreatment dosages is performed.
Results
Reading ADD increased (P<0.01) from="" 1.88�0.16="" in="" stage="" iii="" to="" 2.17�0.15="" in="" stage="" iv="" and="" 2.18�0.12="" in="" stage="" v,="" validating="" a="" need="" for="" increasing="" dosage.="" the="" dt="" predicted="" results="" that="" varied="" by="" age,="" micropore="" (mp)="" dose,="" and="" micropore="" placement.="" the="" effect="" of="" lsm="" was="" most="" powerful="" at="" older="" ages.="" increasing="" numbers="" of="" micropores="" add="" greater="" effects.="" location="" and="" depth="" were="" critical="" showing="" increased="" effects="" for="" drof="" recover="" for="" mps="" over="" limbal="" zones="" and="" ideal="" depth="" between="" 75%-85%="" scleral="" thickness.="">
Conclusion
DT predicted human eye responses to LSM treatment, allowing for regression analysis of predictive loss of DRoF and Reading ADD prescription through all stages. To our knowledge this is the first attempt to predict presbyopia dysfunction as a factor of Reading ADD using DT artificial intelligence. giving promise for individualized precision medicine
Presenting Author
Daniel R Neal, PhD, OSA
Co-Authors
AnnMarie Hipsley PhD, Xifeng Xiao PhD, Mitch Jackson MD
Purpose
To compare the quality vision of Intraocular lens (IOL) and non-IOL presbyopic treatments using Modular Transfer function (MTF) and Visual Strehl Optical Transfer Function (VSOTF) to measure optical resolution and performance.
Methods
In this study, two metrics, Modulation Transfer Function (MTF) and Visual Strehl Optical Transfer Function (VSOTF), are utilized to examine the visual performance. Both measurements are dependent on the wavefront spectra and pupil size. The performance of the existing enhanced IOL�s including monofocal, bifocal, trifocal and EDOF IOLs are compared wit Non-IOL therapies including Laser Scleral Microporation (LSM) and anticholinergic presbyopia drops. Measurements were taken with a Dynamic Wavefront aberrometer for five distinct stages of presbyopia progression. Near Activity Visual Questionnaire (NAVQ) was used to measure patient satisfaction.
Results
The comparison of through focus curves and dynamic visual performance at various distances will be offered included influence of pupil size, IOL power, visual acuity, IOL focal points dysphotopsia, spectacle independence and patient satisfaction will be reported.
Conclusion
IOL solutions ( static) are compared with Non-IOL solutions(Dynamic) for presbyopia, illuminating for the first time, a comparison of visual performance using a dynamic wavefront aberrometer through the full clear vision range.
Presenting Author
Mitch A Jackson, MD, ABO
Co-Authors
Olga Rozanova PhD, MD, Robert Edward Ang MD, AnnMarie Hipsley PhD
Purpose
To assess restoration of binocularity using dynamic fusional ability and binocular summation after Laser Scleral Microporation (LSM) therapy for vision recovery in presbyopes.
Methods
In an IRB registered pilot study at Asian Eye Institute, Philippines, 44 eyes of 22 of Emmetropic presbyopic patients without concomitant pathology were valuated and treated with LSM therapy for vision recovery. Visual function under monocular and binocular conditions was investigated using ultrasound biomicroscopy, aberrometry, standard ETDRS charts, and pupillometry. Nearest point of clear vision, UCVA and DCVA at near (40cm) and distance (5m). Evaluation of the effects of the Laser Scleral Microporation (LSM) procedure on binocular fusion and calculation of �Area of Binocular Summation� (ABS) and Mean stereopsis is reported. ?Patients were followed out 12 months.
Results
The shift of image focus zone in presbyopia is accompanied by suppression of binocular fusion decreasing the degree of binocular summation. Results from an IRB registered prospective single arm pilot study are offered for presbyopic patients over a several-month follow up period following the LSM procedure.? Reported results include distance-corrected intermediate and near visual acuity, add power, aberrometery, and area of binocular summation.??Stereopsis showed improvement over time.
Conclusion
Disintegration of binocular interaction is one of the key mechanisms of reduced visual performance in presbyopia. Monocular presbyopia treatments directly reduce binocularity.? LSM is a bilateral treatment, which not only improves Dynamic Range of Focus (DRoF) for UNVA,DCNVA but also improves quality of vision through improved binocularity.
Presenting Author
James Katz, MD
Co-Authors
AnnMarie Hipsley PhD, Dagny Zhu MD, Molly Duong OD
Purpose
Explore objective and subjective methods to evaluate presbyopia, focusing on reducing chair time and improving clinical outcomes.
Methods
Subjective and objective evaluation of presbypia are presented. Visual acuity, lens quality, and visual quality measurements used to assess vision were evaluated. Dynamic Range of Focus (DRoF) was assessed using an innovative Hartmann-Shack dynamic wavefront aberrometer DWA). The DWA was used to measure visual acuity, higher order aberrations, multifocality, pupil effects, accommodation, and pseudoaccommodation as a measure of quality through focus vision.
Results
A Patient attention was improved using modern targets and feedback. Key DRoF elements were measured dynamically from -5D to +5D, including accommodation, extended Depth of Focus, pseudoaccommodation, and pupil change. Better DCNVA was associated with improved Activities of Daily Living (ADLs) and patient satisfaction. Case Studies of results after Laser Scleral Mcroporation(LSM) are presented, showing through focus curves for clear vision through all distances.
Conclusion
A novel DWA was able to provide a real time dynamic evaluation through the cycle of disaccommodation (far) to accommodation (near), illuminating patient-specific burdens of presbyopia in one device potentially reducing chair time. LSM case studies measured with DWA demonstrated an objective measurement of through focus clear vision.
Presenting Author
AnnMarie Hipsley, PhD
Co-Authors
Xifeng Xiao PhD, Laurent Sabatier MSc, Edwin Price PhD, George Waring MD, Daniel Neal PhD, James Katz MD
Purpose
To review normative curves of various metrics of near vision, and to determine a normative curve for DRoF as measured by the WaveDyn dynamic aberrometer through five stages of presbyopia.
Methods
A total of 108 patients with otherwise healthy eyes, aged 18 to 65 years; enrolled in this study in accordance with the Declaration of Helsinki. Dynamic Range of Focus (DRoF) was measured using a Dynamic Wavefront Aberrometer, incorporating all key visual quality factors: accommodation, pseudoaccommodation, extended depth of focus, and pupil effects. Through-focus curves for Visual Strehl Optical Transfer Function (VSOTF) were generated. DRoF calculations were performed using an integrated algorithm. Based on their DRoF values, subjects were classified into presbyopia Stages I through V.
Results
Preliminary assessments of ten patients (18�59 years) showed 60% male and 40% female distribution. Both accommodative amplitude and DRoF declined with age across the far-to-near range, with DRoF averaging 1.3 D greater. Trends were largely linear (R�=0.72-0.84), though DRoF fit better with a power curve (R�=0.82). Accommodative amplitude, measured via VSOTF through-focus, peaked at ~8 D in 18-year-olds and fell below 1 D by age 50, aligning with previous findings and reinforcing the link between accommodation and optical quality.
Conclusion
These findings confirm the Dynamic Wavefront Aberrometer and algorithm's effectiveness in assessing visual quality via DRoF. Additional data will refine the normative DRoF curve. VSOTF enhances analysis by measuring retinal image quality, complementing DRoF in tracking age-related changes and optimizing optical corrections.
Presenting Author
Mitch A Jackson, MD, ABO
Co-Authors
AnnMarie Hipsley PhD, Robert Edward Ang MD, Cristos Ifantides MD, MBA
Purpose
Chronological age refers to the number of years a patient has been alive, while biological age refers to how old their cells and tissues are, based on physiological evidence. We evaluated presbyopes as a function of visual (biological) age, potential rejuvenation of near visual function by Laser Scleral Microporation (LSM).??
Methods
100 eyes of 50 emmetropic presbyopes received LSM therapy. DCNVA at 40 cm was measured at baseline, and repeated at 3, 6, 12, 18, and 24 months. Visual age was calculated: age = (DCNVA+0.455)/0.014, based on a published correlation between DCNVA and chronological age. Rejuvenated age was expressed in years of rejuvenation from baseline when compared with untreated presbyopes with normal progression of the disease. Comparison of biological age versus chronological visual age of LSM treated patients with untreated age-matched cohort is presented.
Results
The visual age significantly improved from baseline of 67.2�10.1 years to 48.3�11.0 at 6 months and 51.9�8.8 years at 12 months (P<0.0001 at="" all="" timepoints)="" after="" lsm.?="" recovery="" of="" drof="" was="" demonstrated="" by="" an="" improvement="" of="" dcnva="" from="" logmar="" 0.49�0.14="" at="" baseline="" to="" 0.22�0.15="" at="" 6="" months,="" and="" 0.27�0.12="" at="" 12="" months=""><0.0001 for="" all).="" lsm="" is="" noninvasive="" without="" occurrence="" of="" vision="" threatening="" complications.="" lsm="" appears="" to="" recover="" approximately="" 17.5�11.9="" years="" of="" visual="" age=""><0.0001) in="" emmetropic="" presbyopes="" stable="" through="" 12="">
Conclusion
Emmetropic presbyopes who received LSM had an immediate rejuvenation of biological visual age expected loss of DRoF at baseline when compared to untreated age-matched cohort sustained over 12 months. LSM therapy appears to address the crosslinking that accumulates with chronological age reversing visual age to more youthful function.
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