Sunday, September 14, 2008

Near vision gains impressive after intrastromal femtosecond laser treatment for presbyopia

Preliminary results suggest intrastromal treatment using the Femtec femtosecond laser (20/10 Perfect Vision) is a promising new approach for presbyopic correction, said Sinan Goker, MD at the XXVI Congress of the ESCRS.

This flap-free, intracorneal procedure was developed by Luis Ruiz MD, Bogota, Colombia, in 2007. Dr Goker reported that he has been using the Femtec femtosecond laser since 2004 for flap creation and various other applications and has performed the intrastromal presbyopic treatment in 86 eyes of 51 patients since February 2008. All eyes were either emmetropic or slightly hyperopic, and each was treated with a customised photodisruption pattern based on keratometry, refraction, age and central corneal thickness. All patients were seen at one week and one month post-treatment, and two eyes had follow-up to six months.

Comparisons of baseline and postoperative data showed significant improvements were achieved in both mean UCNVA (from J13.3 to J2.3) and mean UCDVA (from 0.64 to 0.80). Whereas patients needed an average near add of +2.6 D to read J1 preoperatively, the same level of near vision was achieved at three months with a mean add of only +0.92 D.
BSCVA remained unchanged in 88 per cent of eyes, while one eye lost two lines and three eyes lost one line. Two of the latter cases resolved with treatment for dry eye. Mean BSCVA was slightly but significantly reduced from 0.99 to 0.95.

Corneal imaging using the Pentacam (Oculus) showed the intrastromal treatment caused no change in central corneal thickness while K1 as well as anterior and posterior surface asphericity were slightly increased.

“This is a very fast, non-invasive treatment for presbyopia with potential safety advantages relating to the absence of any flap or surface ablation, and unlike other presbyopia treatments, it does not disturb distance vision,” said Dr Goker, an ophthalmologist at Istanbul Surgery Hospital, Turkey.

“However, these are early results. Further follow-up in more eyes is needed to determine the long-term stability and predictability, and we are also developing nomograms for treating presbyopia in myopic and astigmatic eyes.”

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