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18 month outcomes of dynamic range of vision outcomes following laser anterior ciliary excision procedure in Asian eyes

Poster Details

First Author: M.Jackson USA

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

Abstract Details



Purpose:

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

Setting:

This single arm IRB monitored clinical trial was performed at Chang Gung Memorial Hospital in Taipei, Taiwan

Methods:

A prospective single arm clinical trial was used to evaluate the LaserACE procedure results over an 18 month period. The patient follow-up period was a minimum of 12 months and up to 18 months. Up to 24 subjects >40 years of age with a demonstrated loss of accommodative ability, good uncorrected distance vision with less than 1.00 D of refractive astigmatism, and otherwise healthy eyes were evaluated. LaserACE was performed using a 2.94 ┬Ám Er:Yag laser in 4 quadrants on the sclera over the ciliary muscle in three key physiological zones to improve biomechanical accommodative forces. Primary study targets were improvement of DCIVA and DCNVA with no significant loss of DCVA, as well as UCNVA and UCIVA. Steroacuity with near correction and the CatQuest survey were also utilized. Objective accommodative ability was measured using the iTrace at 40 cm and 60 cm.

Results:

All patients achieved improvement of near and intermediate vision. An average of 3 lines of vision improvement with improvement in stereoacuity were noted. Postoperatively, DCIVA (60 cm) was 20/30 or better in 100% of subjects, while 93% were 20/25 or better, and 79% were 20/20 or better. DCNVA (40 cm) improved to 0.12 LogMAR at 18 months, compared to 0.20 LogMar preoperatively. Average accommodative power was greater than 1.50D at 18 months using objective measurements, significantly improved from baseline. CatQuest survey revealed high patient satisfaction following the procedure.

Conclusions:

LaserACE procedure using the VisioLite Er:Yag laser appears to be a safe and effective procedure for restoring range of visual performance for near (40cm) and intermediate (60cm) visual tasks without compromising DCVA or stereopsis. Patient satisfaction was high post-operatively and sustained over 18 months. Accommodation was significantly improved and maintained over the 18 month follow-up period. Visual function at near and intermediate distances while wearing distance correction was significantly improved, as was uncorrected near visual acuity. FINANCIAL INTEREST: One of more of the authors... research is funded, fully or partially, by a company producing, developing or supplying the product or procedure presented, One of more of the authors... travel has been funded, fully or partially, by a company producing, developing or supplying the product or procedure presented

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