Presbyopic implant surgery successful only for short term

PHILADELPHIA – A surgical implant specially designed to treat presbyopic patients had disappointing long-term results in a clinical trial in Canada, according to a lecturer here at the Primary Care Optometry News Symposium.

The RestorVision Reading Implants are based on the Helmholtz theory of improving ciliary muscle function. Two to four reading implants were surgically placed in only one of the patient’s eyes, within scleral tunnels. The lenses had a dolphin tail at one end to minimize the chances of the implant falling out.

Lecturer Sondra R. Black, OD, said she and her colleagues at TLC Laser Eye Center of Toronto heard about the surgery and flew to Juarez, Mexico, to see it being performed.

The results were impressive, at first, she said.

“We watched the surgery being done, and the next day we saw these patients,” Dr. Black said. “They were sitting up and reading and they were happy.”

The researchers took the procedure to Canada and performed it on patients there for a clinical trial. They tried both two and four implants first, and then continued with the two implants in the superior quadrants.

“We did have good results in the beginning,” Dr. Black said. “The next day the patients were reading well, but what we found was that somewhere around the 12-month mark the effect started to disappear. We’re not quite sure why.”

Many of the patients complained that the implants were uncomfortable and causing dry eye, she said. Some of the implants eventually popped out as well.

“Women would complain that you could see the implant, and they didn’t like the cosmetic appearance,” Dr. Black continued.

“We took out 90% of the implants we put in,” Dr. Black said. She and her colleagues have not completely written off the procedure.

“We think there may be some potential there, but they’d have to change the placement of the implants,” she said. “And they might have to change the design.”