2016 - 3 Issue

Original article

First Experience with Femtosecond Laser Presbyopia Correction Method Intracor

Full Text links

Summary

We report the first experience with presbyopia correcting femtosecond laser surgical procedure INTRACOR. This procedure is so far the only one that is made purely intrastromally without generating a wound connected to corneal surface or anterior chamber. Presbyopia – caused by physiological aging and decreasing elasticity of the lens, impairs patient’s accommodative ability. In the case of the method INTRACOR, presbyopia is corrected by steepening of corneal curvature in the central optical zone. Procedure is usually performed only in the non-dominant eye.

Methods: Intracor procedure was performed in 10 eyes of 10 patients (3 women and 7 men, aged 47–58 years). All procedures were performed with the femtosecond laser VICTUS (Bausch - Lomb, USA) in the non-dominant eye by an experienced surgeon.

Results: One-year follow-up. Mean monocular uncorrected near visual acuity (UNVA) improved from 0.2 ± 0.1 before surgery to 0.7 ± 0.3 after treatment (mean improvement of four lines). Mean near uncorrected binocular visual acuity (UNBVA) improved from a mean preoperative value of 0.23 ± 0.08 to a mean postoperative value of 0.8 ± 0.22 (mean improvement of about 5 lines). The mean monocular uncorrected distance visual acuity (UDVA) was 0.9 ± 0.1 before surgery and 0.8 ± 0.3 after treatment (average loss of 1 line). The mean binocular uncorrected distance visual acuity improved from 1.0 ± 0,1 to 1,3 ± 0.3 after surgery. All patients had improvements in near vision. In 3 patient, monocular distance vision improved, in 6 patient improved binocular distance vision. We observed statistically significant decrease (mean loss of 1 line) of monocular best corrected distance visual acuity (BCDVA). Patients subjectively reported satisfaction with the quality of vision achieved for near and distance and high levels of spectacle independence under good lighting conditions. The results shows that INTRACOR method is well suitable for low hyperopic patients, who because of good distance visual acuity are not good candidates for refractive lens exchange with multifocal intraocular lens implantation.

References

  1. Bischoff G.: Compensation for presbyopia using contact lenses [German]. Ophthalmologe, 2006;103(8): 655–658, 660.
  2. Holzer MP, Rabsilber TM, Auffarth GU.: Presbyopia correction using intraocular lenses [German]. Ophthalmologe, 2006; 103(8): 661–666.
  3. Fintelmann RE, Naseri A.: Prophylaxis of postoperative endophthalmitis following cataract surgery: current status and future directions. Drugs, 2010; 70(11): 1395–1409.
  4. Semoun O, Bourcier T, Dupas B, et al.: Early bacterial keratitis after presbyopic LASIK. Cornea. 2008; 27(1): 114–116.
  5. Intracor Patient selection, Technolas PV, Munich.
  6. Ruiz LA, Cepeda LM, Fuentes VC.: Intra - stromal correction of presbyopia using 28(3): 182–188.
  7. Ruiz, LA.: Preliminary clinical results with 11-months follow-up of intrastromal correction of presbyopia (intraCORTM) using the FEMTEC® femtosecond laser system. Dostupné na: https://www.scribd. com/document/23193238/100373-Luis- Ruiz-White-Paper-0908-Final.
  8. Holzer M., Mannsfeld A., Ehmer A., Auffartht G.U.: Early Outcomes of IN- TRACOR Femtosecond Laser Treatment for Presbyopia. J Refrac Surg [online], 2009, 25(10): 855–861.
  9. Holzer M.P, Knorz M.C., Tomalla M., Neuhann T.M., Auffarth G.U.: Intrastromal Femtosecond Laser Presbyopia Correction: 1-year Results of a Multicenter Study. J Refrac Surg [online], 2012,
  10. Khoramnia R., Holzer M.P., Fitting A., Auffartth G.U., Rabsilber T.M.: Funktionelle Ergebnisse nach Korrektur der Presbyopie mittels bilateraler intrastromaler Femtosekundenlaserbehandlung. Der Ophthalmologe [online], 2013, 110(12): 1163–1170.
  11. Thomas B.C., Fitting A., Auffarth G.U., Holzer M.P.: Femtosecond Laser Correction of Presbyopia (INTRACOR) in Emmetropes Using a Modified Pattern. J Refrac Surg [online], 2012, 28(12): 872–878.
  12. Khoramnia R., Fitting A., Rabsilber T.M., Thomas B.C., Auffartth G.U., Holzer M.P.: Intrastromal femtosecond laser surgical compensation of presbyopia with six intrastromal ring cuts: 3-year results. Brit J Ophthalmol [online], 2015, 99(2): 170–176. Patient no. 1 Patient no. 2 Patient no. 3 Patient no. 4 Patient no. 5 Patient no. 6 Patient no. 7 Patient no. 8 Patient no. 9 Patient no. 10 Patient no. 1 Patient no. 2 Patient no. 3 Patient no. 4 Patient no. 5 Patient no. 6 Patient no. 7 Patient no. 8 Patient no. 9 Patient no. 10 UDVA preoperative UDVA 1 month UDVA 1 year UDVA preoperative UDVA 1 month UDVA 1 year