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Accommodative improvements and biomechanical changes in macaque non-human primates after laser scleral microporation

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Session Details

Session Title: Vision & Accommodation Assessment

Session Date/Time: Monday 24/09/2018 | 14:00-16:00

Paper Time: 15:06

Venue: Room A3, Podium 2

First Author: : J.Mehta SINGAPORE

Co Author(s): :    A. Hipsley   Y. Liu   B. Hall              

Abstract Details


To evaluate accommodative and biomechanical changes in macaque non-human primates after the Laser Scleral Microporation (LSM) procedure for presbyopia therapy.


Singapore National Eye Centre


An Er:YAG laser was used to rejuvenate age-related ocular rigidity in 5 critical zones of anatomical and functional significance. Twelve eyes of six monkeys were treated: Young (<10 years of age N=2) and Old with loss of accommodation (>10 years of age N=4). Ranges of distance and near vision were created using pharmacological stimulation; cycloplegic drops for distance, and pilocarpine drops for near. Ray-tracing aberrometry and double-pass wavefront were used to objectively measure accommodation. Intraocular Pressure (IOP) was assessed using a pneumatic tonometer. Immunochemistry analysis was done with the markers for inflammation, fibrosis, wound healing, and proliferative activity.


LSM provided improvement in true physiological accommodation, pseudoaccommodation, and effective range of focus. For old monkeys, true accommodation improved by 3 D at 5 months postoperatively, while effective range of focus improved by 4 D. Positive changes after the LSM procedure were also seen in both spherical aberration and depth of focus, which contributed to improvements in pseudoaccommodation. Additionally, average IOP was 13.0 ± 0.8 mmHg preoperatively and significantly improved to 10.1±2.2 mmHg 5 months postoperatively (p=0.0000014). No obvious inflammatory cells or fibrotic reaction was observed. Data collection is ongoing.


Preliminary results show LSM to be a safe and effective procedure for improving accommodation in non-human primates without touching the visual axis. Positive changes in IOP and overall resting and dynamic spherical aberrations suggest that the posture of the lens may be changed as a result of this treatment. Improved wound healing may affect LSM treatment efficacy and increase the accommodation restoration in presbyopes using a primate model.

Financial Disclosure:

... gains financially from product or procedure presented, ... receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented, ... is employed by a for-profit company with an interest in the subject of the presentation

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