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Transcript of SK Kwok, MD Hong Kong Laser Eye Centre, Hong Kong The author has no financial interest in the...
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
J4
J6
J9
J12
J14
Pre-op n = 128
1D n = 126
1W n = 96
1M n = 68
3M 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 VA
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 = 128
1D n = 126
1W n = 96
1M n = 68
3M 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
% o
f eye
s
Pre-Op D1 W1 M1 M3
Pre-op n = 128
1D n = 126
1W n = 96
1M n = 68
3M 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
% o
f eye
s
Pre-Op D1 W1 M1 M3
Pre-op n = 128
1D n = 126
1W n = 96
1M n = 68
3M 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