Femtosecond-based intrastromal treatment shows promise in correcting presbyopic patients

BERLIN — A femtosecond-based intrastromal correction of presbyopia appears to be a fast, safe and reproducible procedure, according to a physician speaking here.

"The treatment requires no incision, no flap, no pocket. The epithelium remains untouched, and the treatment is completely performed intrastromally, creating a series of five consecutive rings at predefined distances," Mike P. Holzer, MD, said at the European Society of Cataract and Refractive Surgeons meeting.

At the University of Heidelberg, Germany, 20 consecutive patients were treated with the new procedure. Mean patient age was 56 years. All of the patients were presbyopic without any higher myopia or hyperopia.

"The procedure lasted just a few seconds. After surgery, the lines of the rings could be seen in transparency, but at 1 week, they had almost completely disappeared," Dr. Holzer said.

Mean near visual acuity improved from 20/100 to 20/40, and no change in distance acuity was reported.

There was some degree of individual variation in the results, he said, but some slightly poorer results were probably due to corneal edema and will probably improve over time. However, the gain in some patients was remarkably higher compared with mean values.

"We treated only one eye, due to our ethic committee restrictions, but binocular vision is still good in all the patients," Dr. Holzer said.

The treatment has a potential to correct all refractive errors, he said. It is noninvasive, and there is no risk of infection because there is no opening of the cornea. So far, tests on biomechanics have shown no weakening of the cornea.