Academic Ophthalmology, School of Medicine, University of Nottingham, Nottingham, UK.
Department of Ophthalmology, Queen's Medical Centre, Nottingham, UK.
Transl Vis Sci Technol. 2022 Dec 1;11(12):2. doi: 10.1167/tvst.11.12.2.
To examine the ocular changes in accommodation, wavefront aberrations, and dynamic range of focus (DROF) after laser scleral microporation (LSM) for treating presbyopia.
Four presbyopic aged cynomolgus macaques (>13 years; n = 8 eyes) were included. All eyes received LSM with erbium: yttrium-aluminum-garnet laser. Spherical equivalent, true accommodation, pseudo-accommodation, wavefront aberrations, and extended range of focus (EROF), or collectively known as DROF, were evaluated using a ray tracing aberrometer. True accommodation referred to the difference in spherical equivalent between distance and near vision, whereas EROF (sum of true and pseudo-accommodation) was determined by measuring the difference in diopters (D) between near and distance through-focus curves, at 50% threshold of the visual Strehl ratio of optical transfer function.
From before to seven months after surgery, there was a significant increase in true accommodation from 0.6 ± 1.0 D before surgery to 5.9 ± 2.8 D at seven months after surgery (P < 0.001). EROF increased significantly from 3.4 ± 1.0 D before surgery to 11.1 ± 4.6 D at seven months after surgery (P < 0.001). Ocular aberrations did not vary significantly between preoperative and various postoperative timepoints in either disaccommodated or accommodated states (P > 0.05). No adverse event such as scleral perforation or hypotony was noted.
This non-human primate study demonstrated that LSM serves as a novel therapy for improving accommodation and DROF function biomechanically, with a positive response observed throughout the seven-month postoperative period.
This proof-of-concept study highlights the potential of LSM as a novel treatment for vision recovery in presbyopic eyes.
研究激光巩膜微孔成形术（LSM）治疗远视时的调节变化、波前像差和动态焦点范围（DROF）。
纳入 4 只（8 只眼）年龄较大的食蟹猴（>13 岁）。所有眼睛均接受铒：钇铝石榴石激光 LSM。使用光线跟踪像差仪评估等效球镜、真实调节、假性调节、波前像差和扩展焦点范围（EROF），或统称为 DROF。真实调节是指距离和近视力之间的球镜等效差异，而 EROF（真实调节和假性调节之和）通过测量近距和远距通过焦点曲线的屈光度（D）差异来确定，以光学传递函数的视觉斯特尔比值的 50%阈值为标准。
从术前到术后 7 个月，真实调节从术前的 0.6±1.0D 显著增加到术后 7 个月的 5.9±2.8D（P<0.001）。EROF 从术前的 3.4±1.0D 显著增加到术后 7 个月的 11.1±4.6D（P<0.001）。在未调节和调节状态下，手术前后各时间点的眼像差均无显著差异（P>0.05）。未观察到巩膜穿孔或低眼压等不良事件。
这项非人类灵长类动物研究表明，LSM 是一种改善调节和 DROF 功能的新型治疗方法，在术后 7 个月的观察期内观察到了积极的反应。
杨阳
