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        Novel Treatment Corrects Near Vision Loss in Older Patients: Presented at AAO

        By Earl R. Nichols

        NEW ORLEANS -- October 28, 2004 -- A novel procedure called near vision conductive keratoplasty has been approved by the United States Food and Drug Administration to correct age-related near vision loss in older patients whose vision is not significantly impaired, it was announced here on October 25th at the American Academy of Ophthalmology Annual Meeting.

        In clinical trials, this procedure has made it possible for older people to read a newspaper -- or even smaller print -- without glasses, explained Marguerite McDonald, MD, Clinical Professor of Ophthalmology, Tulane University, New Orleans, Louisiana, United States.
        .
        Near vision conductive keratoplasty involves burning up to 24 tiny treatment spots on the cornea, in closely controlled concentric rings, in a pattern rather like what is seen on a dartboard. Each of the treatment spots results in a shrinking of the collagen in the cornea, which tightens the corneal structure and induces "closely controlled myopia" amounting to 1.0 to 1.5 diopters in the non-dominant eye.

        Dr. McDonald presented findings from a study on 112 eyes that required 0.75 to 3.00 diopters correction and no more than a 0.75-diopter cylinder. The mean age of the patients was 53 years.

        At the 12-month postoperative follow-up, 89% of subjects were able to read the print in a newspaper or even smaller print without glasses, compared with fewer than 15% of subjects at baseline. Overall, 52% of patients had 20/20 binocular uncorrected distance vision preoperatively, compared with 97% at 1-year postoperative.

        At the 6-month follow-up visit, 81% of subjects said they were able to sew, 90% could read on a computer screen, 86% could fill in a golf scorecard and 65% could read fine print.

        All of the patients reported their quality of depth perception as being "fair to excellent" after the procedure, and the majority said they felt comfortable leaving the house without their glasses and being able to perform most daily tasks.

        This procedure is only meant for people who have some vision loss associated with age -- presbyopia -- and would not be applicable for those who need more than 2.0 dioptres correction. In the United States, more than 80% of people who need glasses after 40 years of age need corrections of -1 to +2.0 dioptres, Dr. McDonald noted, and, therefore, there is a potentially huge market for this procedure.


        [Presentation title: "Conductive Keratoplasty for Presbyopia: FDA Clinical Trial 12-Month Results." Abstract 135]



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