Results of clinical research on new presbyopia treatments now available in Europe – and possibly available soon in the US – were reported Oct 19 at an international ophthalmologist conference in Chicago.
Presbyopia is Inevitable
From age 40 onward our eyes' lenses gradually lose the ability to focus on close-up objects, a condition called presbyopia which involves loss of the lens/cornea flexibility needed to switch between near and distance vision. (In Greek, presbyopia means “old eye.”)
By our 50s or 60s, almost everyone experiences blurry near vision, although distance vision often remains good (while near-sighted people experience more blurry distance vision).
More than 60 million people in the United States are presbyotic, as are more than 400 million worldwide. Reading glasses are one solution, but many people are interested in glasses-free vision correction.
Options now available include a type of laser (Lasik) surgery or a contact lense that can improve near vision in one eye, called monovision; and Ben Franklin’s bifocals.
But within a few years, new presbyopia treatments will likely be available in the U.S.
Ioannis G. Pallikaris, MD, University Hospital of Crete, Greece, reported on a new type of micro-lens, the Flexivue,* that was implanted in the corneas of 15 patients, who were followed for 12 months post-surgery.
• In a procedure lasting about 10 minutes, an extremely thin lens was inserted into the cornea (the clear outer structure) of the patient's non-dominant eye through a tiny pocket made with a highly precise femtosecond laser.
• The specific vision-correcting prescription for each patient was incorporated in the outer area of the lens.
• After lens insertion, the pocket self-sealed and held the lens in place.
• On average, treated eye near vision improved from 20/100 to 20/25 without glasses, and distance vision decreased from 20/20 to 20/40.
• Vision remained stable in both eyes post-surgery in all patients through the follow-up period.
"This corneal lens implant appears to be a safe, effective way to correct presbyopia in people aged 45 to 60," said Dr. Pallikaris.
• "98% of patients were satisfied with their vision;
• 69% reported 'excellent' and 30 percent 'good' near vision in our survey;
• 92% said they no longer used glasses."
He said there were no surgery-related complications, but about 15% of patients reported glare and/or halos around lights, and some had reduced contrast sensitivity.
Distance vision in the implanted eye is less influenced and remains better than it would be when a Lasik monovision procedure corrects for near vision. Dr. Pallikaris called this advantage "smart monovision."
Can Be Reversed/Removed
Another key advantage is that, unlike Lasik and related refractive surgical procedures, the effects of corneal lens implants can be reversed by lens removal.
Dr. Pallikaris was one of the pioneers of Lasik in the early 1990s.
Not For Everyone
He stressed that proper patient selection is crucial to the success of the microlense:
• The candidate should have worn reading glasses for at least one year;
• Patients would be disqualified if they have certain types of astigmatism (an irregularity in the curve of the cornea), lens opacity (cataract) or several other conditions.
* Financial disclosure: Dr. Pallikaris states that he is chair of the medical advisory board of Presbia, the company that makes Flexivue.
Source: American Academy of Ophthalmology news release Oct 19, 2010