Scleral spacing procedures showing restoration of accommodation

Issue: December 25, 2010

NEW YORK — While they have been slow to gain wide acceptance in the ophthalmology community, scleral spacing procedures have shown the ability to restore accommodation in presbyopic eyes, according to one presenter here.

Speaking specifically about the LaserACE scleral spacing procedure, Marguerite B. McDonald, MD, FACS, presented clinical trial results at OSN New York 2010 showing a short-term improvement in vision as well as a restoration of accommodation as measured by a wavefront COAS-HD objective dynamic accommodation analyzer (WaveFront Sciences).

At 18 months, 59 of 67 patients who underwent the procedure saw 20/20 or better uncorrected at distance, and 64 of 67 patients saw J3 or better at intermediate distance uncorrected.

"LaserACE appears to restore natural dynamic accommodation, thus improving vision at all ranges with no clinically significant complications," Dr. McDonald said. "Everyone got better, and no one got worse."

"There is very little risk of complications, and by the way, you cannot cosmetically detect that surgery has taken place," she said.

Dr. McDonald noted that the LaserACE procedure, developed by Ann Marie Hipsley, DPT, PhD, is minimally invasive and does not affect the shape or power of the cornea or the lens. The procedure acts by increasing scleral viscosity and strengthening the ciliary muscles.

There is high demand for a safe and effective treatment for presbyopia. The clinical trial results of the LaserACE procedure presented by Dr. McDonald appear promising. Patients maintained good distance vision and also achieved improvements in uncorrected near vision. As more patients undergo the LaserACE procedure within clinical trials, we can hopefully better understand the range of near vision improvement that can be expected, as well as the risks associated with this procedure.

– William B. Trattler, MD
OSN SuperSite Editorial Board member