sk kwok, md hong kong laser eye centre, hong kong
DESCRIPTION
ASCRS 2011 San Diego, US. Preliminary Clinical Outcomes of a Non-Invasive, Intrastromal Presbyopic Correction in Asian Eyes. SK Kwok, MD Hong Kong Laser Eye Centre, Hong Kong. The author has no financial interest in the subject matter of this e-poster. Background & Study Purpose. - PowerPoint PPT PresentationTRANSCRIPT
SK Kwok, MDHong Kong Laser Eye Centre, Hong Kong
The author has no financial interest in the subject matter of this e-poster
ASCRS 2011San Diego, US
Preliminary Clinical Outcomes of a Non-Invasive, Intrastromal Presbyopic
Correction in Asian Eyes
Background & Study PurposeStudy Purpose: To evaluate the preliminary clinical outcomes of INTRACOR intrastromal presbyopic correction in Asian Eyes.
ASCRS 2011, SK Kwok
•The INTRACOR procedure is performed on a femtosecond laser (TECHNOLAS Perfect Vision).•The laser forms a series of concentric rings within the stroma which causes a localised change in the biomechanical properties of the stroma.•This leads to a central steepening of the cornea.•The procedure takes 20 seconds to perform.•The procedure uses a curved Patient Interface which adapts to the natural shape of the cornea, without applanation, reducing the increase in IOP when applying suction
Note: INTRACOR is not currently approved for use in the US
Methods & MaterialsA prospective, non-comparative case series where the INTRACOR procedure wasperformed on 128 eyes of Asian patients using the TECHNOLAS Femtosecond Workstation 520F (Technolas Perfect Vision).• The non-dominant eye was treated first.
Patient Demographics:• 79 Females and 49 Males patients• Mean Age : 53 years old (range: 41 - 66)• 58 OD were treated; 70 OS were treated
Pre-operative examinations: Included distance and near vision, corneal, topography, slit lamp examination and patient satisfaction
Measured outcomes:Visual acuity (UCNVA, UCDVA, BCDVA), Refractive outcomes, patient satisfaction• Post-operative follow-up at 1D, 1W, 1M and 3M
ASCRS 2011, SK Kwok
TECHNOLAS 520F
Results: Slit lamp and topography
INTRACOR post-1-week slit lamp INTRACOR Orbscan difference map (post-1-month) •Central steepening by 2.50 – 3.00D
ASCRS 2011, SK Kwok
J1
J2
J4
J10
J6
J1+-0.08
LogMAR
0
0.1
0.2
0.4
0.7
Results: UCDVA & UCNVA
0.830.73 0.74 0.79 0.78
0.18
0.660.73 0.72
0.79
0.00
0.20
0.40
0.60
0.80
1.00
1.20
PreOp (128) D1 postop (126) D7-14 postop (96) M1 postop (68) M3 postop (20)
Visit
UCDVA UCNVA
J10
J2
ASCRS 2011, SK Kwok
PreOp (128) D1 postop (126)
D7-14 postop (96)
M1 postop (68)
M3 postop (20)
-0.50
0.00
0.50
1.00 0.94
0.04 0.02 0.120.05
Sphere over time
Visit
Diop
tre
(D)
PreOp (128) D1 postop (126)
D7-14 postop (96)
M1 postop (68)
M3 postop (20)
-0.50
-0.25
0.00
0.25
-0.36-0.32 -0.30 -0.27
-0.37
Cylinder over time
Visit
Diop
tre
(D)
Results: Refractive stability
ASCRS 2011, SK Kwok
PreOp (128) D1 postop (126) D7-14 postop (96)
M1 postop (68) M3 postop (20)-0.50
-0.25
0.00
0.25
0.50
0.75
1.000.76
-0.12 -0.13 -0.02
-0.13
MRSE over time
Visit
Diop
tre
(D)
J1
J4J6J9
J12
J14
Pre-op n = 1281D n = 1261W n = 961M n = 683M n = 20
0.89
0.250.20 0.23
0.130.00
0.20
0.40
0.60
0.80
1.00
PreOp (128) D1 postop (126) D7-14 postop (96) M1 postop (68) M3 postop (20)
LogM
AR V
A
Visit
ASCRS 2011, SK Kwok
Results: UCNVA (LogMAR)
Pre-op 92% J7-J16 N=128
Post-op 1W 71% J1-J3 N=96
Post op 1M 74% J1-J3 N=68
Post-op 3M 80% J1-J3 N=20
Pre-op n = 1281D n = 1261W n = 961M n = 683M n = 20
0.11
0.16 0.160.13 0.13
0.00
0.04
0.08
0.12
0.16
0.20
PreOp (128) D1 postop (126) D7-14 postop (96) M1 postop (68) M3 postop (20)
LogM
AR V
A
Visit
ASCRS 2011, SK Kwok
Results: UCDVA (LogMAR)
Results: Cumulative UCNVA
ASCRS 2011, SK Kwok
Cumulative UCNVA
0% 0% 2% 8%22%
48%35%
54%
74%88% 91%
45%
70%
100% 100% 100%
85%80% 85%
0%
20%
40%
60%
80%
100%
120%
J1 J2 J3 J5 J7 J10 J16
% of
eyes
Pre-Op D1 W1 M1 M3
Pre-op n = 1281D n = 1261W n = 961M n = 683M n = 20
Cumlative Distance BCVA
6.3%
97.7% 100.0%
2.9%0.0%
100.0% 100.0%
88.2%97.1%90.0%
0.0%
20.0%
40.0%
60.0%
80.0%
100.0%
120.0%
6/4.5 6/6 6.7.5 6/9
% of
eyes
Pre-Op D1 W1 M1 M3
Pre-op n = 1281D n = 1261W n = 961M n = 683M n = 20
Results: Cumulative BCDVA
ASCRS 2011, SK Kwok
Results: Patient Satisfaction
• Some patients could see the rings but their vision is not disturbed.
• A few patients encountered halos but the symptoms dissipated after one month.
• Most patients are happy with their enhanced quality of life without reading glasses.
ASCRS 2011, SK Kwok
Conclusion
In my opinion, the intrastromal presbyopia treatment INTRACOR is
• Non invasive so very low risk for infections
• Provides stable refractive outcome during the follow up period to-date
• Provides a significant gain in uncorrected near visual acuity
• Creates a central steepening and induces about –0.50D to –0.75D of myopia
• No weakening of cornea
• High level of patient satisfaction
• Further long-term follow-up required to confirm stability of outcomes
ASCRS 2011, SK Kwok