Ray-Tracing Aberrometry Measurement of Optical Properties Contributing to Dynamic Accommodative Power After Laser Anterior Ciliary Excision Procedure

Friday, April 25, 2014
KIOSKS (Boston Convention and Exhibition Center)
Karolinne M. Rocha, MD, PhD, Cleveland Clinic Foundation - Cole Eye Institute, Cleveland, OH, USA
AnnMarie Hipsley, PhD, ACE VISION GROUP, Silver Lake, LA, USA
Mitchell A. Jackson, MD, Jacksoneye, SC, Lake Villa, IL, USA
Tracy Swartz Madison, AL, USA

Narrative Responses:

Purpose
To evaluate serial measurements of dynamic accommodation by ray-tracing aberrometry after Laser Anterior Ciliary Excision (LaserACE) procedure.

Methods
A 2.94um Er:YAG is used to perform partial thickness micro-excisions in the sclera in three critical anatomic zones to reduce ocular rigidity and to restore natural accommodative function.  Ray-tracing aberrometry was used to objectively measure the accommodative range after LaserACE treatment. The range of accommodation in diopters for each eye as well as dynamic changes in defocus, spherical aberration, coma and trefoil were analyzed.

Results
Dynamic wavefront analysis was performed on 3 short-term patients (0-6 months) post-operatively and 3 long-term patients(6-8yrs). Changes in SA, Coma, Trefoil, and defocus during dynamic accommodation are analyzed, and correlated to depth of focus and psuedoaccommodation in both groups.  In general, SA shifted toward negative values in these patients. Detailed results analysis re offered on both short term and long term patients.

Conclusion
Ray-tracing technology can objectively measure dynamic accommodation and is a critical device to differentiate true accommodation from pseudoaccommodation Specific optical correlations were identified during dynamic accommodation pre-op/post-op LaserACE which may explain the improvement in dynamic accommodative capacity and visual acuity in these patients.