Evaluating A Dose Algorithm For Laser Scleral Microporation (Lsm) Therapy For Progressive Presbyopia Using A 3D Finite Element Predictive Model.

To model the effect of multiple doses of LSM treatment through stages of presbyopia from early onset to stable presbyopia.

Ace Vision Group, INC

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Boston, MA 02108

Finite element models were developed for the eye at different stages of presbyopia based on age-specific published literature and imaging data for clinical measurements of shape, biometry, movement, and materials properties.  The effect of performing LSM at Stage I (43-47yrs); Stage II (48-52yrs);Stage III (53-57yrs) and Stage IV (58+ yrs). Three different scenarios were considered, with the effects of the LSM dose at a specific stage and analyzed for length of sustainable effect.

The best-case scenario (2 doses) resulted in an improvement of Dynamic Range of Focus (DRoF) for the patients treated with LSM over the age matched normative population of 10%. The worst-case scenario (1 dose) showed an improvement of 6% over the age matched normative population. Patients who were treated at earlier stages or younger ages and who received more doses responded better than single-dosed patients at any stage. Model validation data demonstrated an underestimation of the effects by 26%. 

Finite Element modelling was able to demonstrate the effects of dosing the LSM therapy. Receiving LSM therapy to uncrosslink destructive bonds in connective tissue of the sclera at an at the onset or earlier stage of presbyopia  may be a preventive and effective measure in delaying the loss of DRoF that occurs with age.