EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
Issue link: https://digital.eyeworld.org/i/115557
February 2011 March 2013 for better ways to improve vision for patients with complex corneal diseases, said Deborah S. Jacobs, M.D., medical director, Boston Foundation for Sight, Needham, Mass. The foundation is well known for its BostonSight PROSE treatment, which uses rigid gas permeable large diameter prosthetic devices custom fit to the eye to restore sight. Dr. Yoon and his lab recently collaborated with the Boston Foundation for Sight to correct HOAs in patients using the foundation's prosthetic devices. In a presentation given at last year's Association for Research in Vision and Ophthalmology meeting, Drs. Yoon, Jacobs, and other researchers shared the results from six patients (11 eyes) with advanced keratoconus. Despite a customized fit, they still had uncorrected HOAs limiting vision. Coma was the most dominant HOA. Most of the HOAs were corrected with the device. "Customized correction resulted in a mean improvement of 1.9 Snellen lines," investigators wrote in their abstract. The use of HOA correction also helped to improve contrast sensitivity. However, the average logMAR visual acuity was 0.21 and the average Snellen acuity was 20/32, despite clear media. Investigators concluded that the device may require longer-term neural adaptation instead of measuring immediately after the introduction of customized correction. Prosthetic devices with wavefront-guided HOA correction as designed by Dr. Yoon's lab are only available now on a research basis, Dr. Jacobs said. A paper with more details about the customized HOAcorrecting lens is in press with Optometry & Vision Science, Dr. Yoon said. The Boston Foundation for Sight does currently offer wavefrontoptimized optics that improve vision for some keratoconus patients, Dr. Jacobs said. Dr. Yoon believes an HOAcorrecting contact lens or prosthetic device could be used in non-keratoconic patients who want super crisp vision. "We're looking into using this technology in a more or less normal population and maybe including a professional sports player who wants really crisp images. Another important application of this technology is a presbyopia-correcting customized lens with a multifocal design," Dr. Yoon said. "The good thing is that this is noninvasive technology if patients don't like it." Dr. Yoon also believes it is useful to apply the HOA-correcting technol- ogy in different ways, just as the lab is doing now. "We have different technology with different lenses, but EW REFRACTIVE SURGERY 87 the goal is the same, to control the higher-order aberrations," he said. EW continued on page 88 We're Changing The Game with our new Model M4 valve. Model M4 Porous Plate www.ahmedvalve.com 800.832.5327