Eyeworld

EW FEATURE 44 where we got 1.5 D or so of poten- tial accommodation change with ob- jective measurement," Dr. Krueger said. "But many other cases we haven't seen any change." Investiga- tors are now working on the pat- terns to try and come up with one that they hope will work the most effectively. Dr. Krueger thinks that successes that LensAR has had of late in using the femtosecond technology for cataract surgery will provide the fi- nancial foundation to continue working on accommodation restora- tion. "In time, I think that we will eventually be able to solve this issue," he said. D. Rex Hamilton, M.D., assis- tant clinical professor of ophthal- mology, and director, UCLA Laser Refractive Center, Jules Stein Eye Institute, David Geffen School of Medicine, University of California, Los Angeles, is hopeful that this may eventually prove successful. "I think that it could be a potentially huge treatment because there are no inci- sions and it's minimally invasive in terms of risk of infection," he said. His one concern is making sure that the procedure does not heighten the risk of cataract development. Liquid crystal in them there hills Another new presbyopic option being considered, about which Dr. Hamilton feels less optimistic, are dynamic spectacles that utilize em- bedded liquid crystals. The new elec- tronic glasses, called emPower (Pixel Optics, Roanoke, Va.), enable users to change the refraction by touching a sensor on the frame, according to Clay Musslewhite, director of mar- keting, Pixel Optics. Inserted be- tween the lenses are liquid crystals, which can rearrange themselves and change the focusing power faster than the blink of an eye, Mr. Musslewhite said. There's also an automatic mode that can be used that activates an ac- celerometer built into the frame. This senses head tilt. "When the wearer is looking straight ahead, the electronic reading zone is off and when the wearer looks down, it turns it on automatically," Mr. Musslewhite said. This mode would have to be activated as well. There are some who question just how robust this technology cur- rently is for use in presbyopic pa- tients and wonder if it will be too distracting to constantly be worry- ing about pushing a button or ad- justing head position to change the status of the near vision. However, Mr. Musslewhite noted that studies with the glasses show that 75-80% of the time wear- ers are not reading something up close and when they are reading, it is usually for an extended 5-10 minute period. He finds that wearers like having the control. "With regu- lar glasses everything is optimized around the fact that the reading power is always there," Mr. Musslewhite said. "But now they have the choice, and our feedback from our wearer studies is that they love that choice." The scleral end of town There are two distinct technologies concentrating on the sclera—Scleral Expansion Bands (Refocus Group, Dallas) and the LaserACE (Ace Vi- sion Group, Silver Lake, Ohio)—that are making presbyopic inroads. With the Scleral Expansion Band technique, segments are put into each of the oblique quadrants of the eye, according to Barrie D. Soloway, M.D., assistant professor of ophthalmology, New York Med- ical College, New York. The mecha- nism remains somewhat uncertain. "It appears as if it tightens the poste- rior zonules to allow for continued shape changes relating to the lens growth as being the problem more so than lens stiffness," Dr. Soloway said. The thinking is that with the February 2011 PRESBYOPIA June 2011 The pioneer continued from page 42 continued on page 46

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