SEBs can be inconsistent, unpredictable, study suggests

TOULOUSE, France — Scleral expansion bands were ineffective in relieving presbyopia in a small study performed here. Francois J. Malecase, MD, said the effects observed in his study were minimal and inconsistent, and thus inadequate to support the use of this modality as a treatment for presbyopia.

Attempts to keep the bands in place, to adjust the placement of the bands — and consequently of the lift — or to induce a more substantial lift with redesigned bands might lead to a higher rate of success, Dr. Malecase said.

Thomas M. Riedhammer, PhD, chief executive officer of Presby Corp., manufacturer of the scleral expansion bands, noted the scleral belt loops Dr. Malecase created were shallow and loose, which he attributed to surgeons who are “a little too cautious” for fear of cutting through the sclera. To help surgeons overcome this fear, Dr. Riedhammer said, Presby has recently introduced a microkeratome-like instrument that makes a standardized cut.

In Dr. Malecase's study, surgery was performed in eight eyes of six patients. Preoperative visual acuity was at least 20/20, and all eyes were emmetropic except one with hyperopia of 0.5 D. Postoperatively, all patients received combination neomycin-dexamethasone drops four times daily for 15 days. The patients were observed 1 day, 1 week, 1, 3 and 6 months and 1 year postop.

Dr. Malecase said that although improvements in near visual acuity were overall minimal, inconsistent and temporary, they were nevertheless unquestionable for three eyes.

Details on Dr. Malecase's study and his surgical technique appear in the Mar. 1 print edition of Ocular Surgery News.