Dynamic Range Of Focus Recovery In Emmetropic Presbyopes After Laser Scleral Microporation: 24 Month Pilot Study Outcomes 

To Evaluate the Dynamic Range of Focus After Bilateral Laser Scleral Microporation (LSM) in Presbyopic Eyes.

Asian Eye Institute, Makati City NCR , Philippines

Scleral microporation was performed bilaterally overlying critical zones in four quadrants using an Er:YAG laser to improve the Dynamic Range of Focus (DRoF) for 50 patients. Patients were over 45 years of age with demonstrated loss of accommodative ability. Visual outcomes were assessed using the Early Diabetic Retinopathy Study (EDTRS) logMAR charts at distance, 60cm and 40cm with and without correction.      

50 patients (71% female) of average age 52.6 (SD 4.0) underwent bilateral LSM.  LSM provided improved monocular DCIVA, DCNVA from 0.16±0.15 and 0.49±0.14 preoperatively to 0.12±0.14 and 0.29±0.13 at 24 months respectively postoperatively (sig for DCNVA; P<0.001).  Binocular intermediate and near visual acuity (DCIVA, DCNVA) improved from 0.12±0.15 and 0.45±0.1 respectively to 0.10±0.14 and 0.29±0.14 (sig for DCNVA; P<0.001) at 24 months postoperatively with no reduction in distance vision. MRSE was not significantly different 24 months postoperatively (P=0.37).  Refractive power required to read letters at the logMAR 0.00 level at 40 cm dropped from 2.0±0.21 D at baseline to 1.3±0.49D (P<0.001) at 24 months postoperatively.  

Early results suggest LSM is a safe and effective procedure for restoring the dynamic range of focus in presbyopes. Early results up to 24 months post-operatively also suggest that LSM can improve intermediate and near visual acuity without touching the visual axis and without comprising distance visual quality.  Data collection is ongoing.