DIRECT PATTERN PROJECTED ANNULUS LASER FOR SCLEROCILIARY TREATMENT OF PRESBYOPIA: AN ALTERNATE APPROACH

This study aimed to evaluate a non-invasive laser correction method for presbyopia ​using a mid IR laser.  Presbyopia, a common age-related loss of near vision, typically necessitates optical correction. The demand for a non-invasive, safe, and effective treatment approach for presbyopia remains significant. ​Recently, Scleral Laser treatments have shown promise in various ophthalmic applications.

Eindhoven Eye Clinic

An initial experience was gained using a mid IR laser directed at 4 quadrants of the sclera for 2 minutes on 150 patients with 1 yr follow up. Outcomes evaluated included an improvement in uncorrected near visual acuity (UNVA) from J11 to J3, a decrease in intraocular pressure (IOP) from 16 mm Hg to 12 mm Hg, ​with the absence of adverse events. Only topical anesthesia and a speculum were employed. Subsequent design improvements incorporated simultaneous 4-quadrant 360-degree laser pattern delivery, ​wavelength enhanced deeper penetration (though not to the choroid plexus), slit lamp adapted for improved visualization and alignment, and an eye-tracking system to enhance precision and facilitate retreatments.

Computer simulations and ex vivo tests validated the safety of the method and its ability to modulate scleral elasticity. A preliminary in vivo patient treatment series was conducted on 50 patients, with outcomes assessed at the 1-month follow-up. Detailed descriptions of the device and its functional performance were provided, along with an assessment of its usability and patient comfort​ along with preliminary follow up outcomes.

The ​investigational study suggests that a cornea and lens-sparing, non-incisional, precise, repeatable, and pain-free laser treatment for presbyopia is potentially feasible. Furthermore, this approach offers the advantage of a low cost of entry, making it a promising solution for presbyopia correction in the future.