Evaluation Of The Correlation Of Depth And Visual Acuity After Laser Scleral Microporation In Presbyopic Eyes Utilizing As-Ss-Oct

To evaluate the effects of optimal depth on the efficacy of DCNVA after Laser Scleral Microporation (LSM) for the treatment of presbyopia using AS-SS-OCT.   

Panama Eye Center, Panamá, Panama

Prospective study of AS-SS-OCT imaging in 60 eyes of 30 presbyopes.   Pre-treatment AS-SS-OCT thickness measurements were used to plan the LSM treatment to achieve the target depth of 85% scleral thickness. Post treatment AS-SS-OCT was used to calculate target treatment depth as it correlates to DCNVA at 1,3,6, and 12 months. A novel annotation tissue segmentation software was used to characterize scleral tissue layers.

ATS image processing software improved assessment, resulting in the smallest mean unsigned error values and associated standard deviations. OCT outcomes were comparable with annotation of conjunctiva and scleral layers from OCT. The microporation characterization was accurate within 10 um for a 265um micropore. (p<0.002).  Comparison with an external AS-SS-OCT showed a 0.2% error rate in LSM patterns validating the onboard adaptive depth control algorithm. AS-SS-OCT pre and post-LSM found at least 70% of the patients received the optimal depth between 75-85%; 30% received between 50-65%.   Patients receiving optimal depth showed statistically significant higher improvement than suboptimal group. (p=0.037)

AS-SS-OCT measurement along with ATS image processing was useful as an optimization planning tool for the efficacy of the LSM procedure to reach and verify the target depth, pore volume fraction, and total treatment.  AS-SS-OCT is a valuable characterization and optimization tool for LSM therapy and will be valuable for dosable nomogram development.