One-Year Dynamic Range of Visual Outcomes After Laser Anterior Ciliary Excision Procedure
Narrative Responses:
Purpose
To evaluate accommodative benefits for dynamic range of vision at 40cm and 60cm for near and intermediate visual performance after bilateral Laser Anterior Ciliary Excision (LaserACE) procedure.
Methods
Prospective single arm design clinical study evaluated the LaserACE procedure results over 12 months. 24 Subjects ≥40 years of age with demonstrated loss of accommodative function, good uncorrected distance vision with less than 1.0D of refractive astigmatism, and otherwise healthy eyes were evaluated.Laser anterior ciliary excision was performed with 2.94um Er:Yag laser in 4 quadrants on the sclera over the ciliary muscle in 3 key zones to improve biomechanical accommodative forces. Primary study targets were improvement of DCIVA (60cm) and DCNVA (40cm) with no significant loss of DCVA. Data was distance at 40cm and 60cm for near and intermediate vision.
Results
All patients achieved some improvement of Near & Intermediate Vision. An average of 2-4 lines of improvement of reading vision was demonstrated. Postoperatively, UIVA was 20/30 or better in 93% of subjects; 86% were 20/25 or better; and 80% 20/20 or better. UNVA was 20/30 or better in 85% of subjects; 80% 20/25 or better; and 46% 20/20 or better. No statistical change was noted in UCDVA post operatively. Average added accommodative power was approximately 1.5D which had clinical significance.
Conclusion
LaserACE procedure with VisioLite Er:YAG laser appears to be a safe and effective procedure for restoring range of visual performance for near and intermediate visual tasks without compromising DVA. Patient satisfaction was high post operatively and sustained over 6-12 months in this group.