Mitchell Jackson
ACE Vision Group, USA
Title: Long-term visual outcomes after laser anterior ciliary excision
Biography
Biography: Mitchell Jackson
Abstract
Purpose: Our purpose was to evaluate the long-term visual outcomes after bilateral Laser Anterior Excision (Laser ACE) for restoring dynamic near and intermediate vision. Setting/Venue: Chang Gung Memorial Hospital (Linkou, Taiwan) registered single arm clinical trial. Methods: 24 patients (48 eyes) over 40 years of age demonstrating loss of accommodative function, good uncorrected distant vision underwent bilateral Laser Anterior Ciliary Excision procedure (LaserACE) using an Er:YAG laser in 4 quadrants on the sclera to improve pliability & biomechanical efficiency of the ciliary muscles in 3 critical zones. Uncorrected distance visual acuity, (UDVA) corrected distance visual acuity (CDVA), uncorrected intermediate at 60cum (UIVA),corrected intermediate (CIVA), uncorrected near at 40cm (UNVA) and corrected near visual acuity ( CNVA) using the Early Diabetic Retinopathy Study [EDTRS] logMAR charts were measured at 1, 3, 6, 12, 24, and 36 months. Results: Mean age 68.70 (Plus or minus) 7.1 (range: 54 to 83 yrs). Mean follow-up was 42.72 (Plus or minus) 0.49 months (range: 42.33 to 43.27). All patients achieved improvement. Pearson Correlation statistical analysis was performed. Postoperatively, DCIVA 20/30 or better in 100% of subjects; 89% 20/25 and 78% 20/20 (p<0.176259477) DCNVA 20/30 or better in 83% of subjects; 67% 20/25 and 50% 20/20 (p<0.007202813). Postoperatively, UIVA 20/30 or better in 89% of subjects; 72% 20/25 and 72% 20/20 (p<0.305284979), UNVA 20/30 or better in 83% of subjects; 78% 20/25 and 33% 20/20 (p<0.046840147). No statistical change in DCVA/UDVA. Clinically significant improvement in stereopsis is from 75.77 to 60 degrees. Conclusions: Laser ACE performed using the Visio Lite Er:Yag laser appears to be a safe and effective procedure for restoring range of visual performance for near and intermediate visual tasks without compromising UDVA/CDVA or binocularity. Stereopsis was not only preserved but improved over time. Patient satisfaction was high post-operatively, and was sustained over the 36 months.