Enabling Precision Medicines To Predict Outcomes For Presbyopia After Laser Scleral Microporation Using 3D Digital Twin Technology
Published 2024 - 42nd Congress of the ESCRS
Reference: FP24.05 | Type: Free paper | DOI: 10.82333/7dx1-qh21
Authors: Annmarie Hipsley* 1 , Robert Ang 2 , Laurent Sabatier 3 , Cristos Ifantides 4
1CEO,Ace Vision Group Inc ,Boston ,United States, 2Asian Eye Institute ,Makati City,Philippines, 3Engineering,Ace Vision Group Inc ,Boston ,United States, 4Ace Vision Group Inc ,Boston ,United States
Purpose
To demonstrate the predictive value of a precision medicine Digital Twin (DT) technology for optimizing treatment outcomes after Laser Scleral Microporation (LSM) therapy for presbyopia.
Setting
Small Business Innovation Research (SBIR) grant application experimental study
Methods
A 3D Digital Twin (DT) of the human Eye was developed using a Finite Element Model (FEM) and an artificial intelligence (AI), machine learning (ML) neural network. Individual patient data validated to literature references of material, biometrical and biomechanical properties was used to assess outcomes of LSM at progressive stages of presbyopia. A dosage algorithm was developed using ML and AI to deliver calculated doses of LSM based upon the stage of presbyopia. Virtual Simulations of progressive doses of LSM to recover Dynamic Range of Focus (DRoF) on twelve eyes are presented. Diopter conversion of Distance-Corrected Near Visual Acuity (DCNVA) to LogMAR was calculated from using a proprietary algorithm.
Results
The DT predicted results varied by subject age, micropore placement and dose (9, 16, 25, 36, or 49 micropores). Older ages demonstrated the most powerful result. For a 40 y.o., a 49-micropore treatment resulted in a minor 9.9% increase in DCNVA. The 49-micropore treatment improved Central Optical Power by 16% in a 50 year old subject. Increasing the number of micropore directly correlated with improved DCNVA. 25 micropore treatment 50 y.o. yielded a 12% increase in DCNVA versus a 49 micropore treatment yielding a 15% improvement. Micropores placed in zone 0v over the ciliary apex resulted in greater changes to DCNVA than centrally in zone 2. Micropore dosage correlated with DRoF recovery for progressive stagse of presbyopia.
Conclusions
A human eye DT was able to predict and optimize LSM treatments offering an opportunity to provide individualized precision medicine. The DT was able to predict treatment algorithms for emmetropic presbyopic patients with progressive stages of aging. Ophthalmological precision medicine is possible using DT technology.