Non-invasive laser may help in corneal reshaping

Optimal keratoplasty (Opti-K, NTK Enterprises), a novel non-invasive laser keratoplasty procedure, is a safe and promising treatment for presbyopia in emmetropes and low hyperopes, reported Sherry L. Audycki, OD, recently.

Performed using a proprietary continuous-wave thulium fiber laser with a sapphire applanation window, the procedure reshapes the cornea and creates a multifocal effect to provide clear distance and near vision, without causing any epithelial disruption and its associated risks and morbidity.

"Optimal keratoplasty is a simple, fast, comfortable, low power laser treatment that is meant to be repeatable. Per protocol, the patients enrolled in our study were treated only in their dominant eye. Now they are excited to have a repeat treatment and treatment in their fellow eye," she said.

Patients participating in the U.S. IDE study were presbyopes with mild hyperopia (SE +1.00 D to +2.00 D). They were scheduled to return for monthly visits; five eyes received a planned secondary treatment to date.

Study results

Follow-up

Tear osmolarity was unchanged. Endothelial cell density decreased slightly, but the change was not different from that recorded in the control eyes. Patients had no subjective complaints of pain, discomfort, dryness, or halos while driving at night.

Other studies also positive

A pilot study of the procedure enrolling emmetropic presbyopes was performed in the Bahamas, where K. Jonathan Rodgers, FRCS(C), DABO, was principal investigator. The procedure is now being offered to patients in the Bahamas outside of the study protocol. It also received the CE mark in Europe and is being performed in Bermuda, Italy, and Switzerland.

"Good results are being achieved in patients treated outside of the United States, and hopefully will provide us with more data to understand the variability in the duration of the treatment effect and allow us to perhaps identify predictive factors that can be used for patient counseling," Dr. Audycki said.

Histological studies in animal eyes show the treatment does not destroy the cornea or cause collagen shrinkage. Rather, it is thought that a change in corneal hydration underlies its clinical effect and that regression occurs over time as a result of rehydration.

FYI

Sherry L. Audycki, ODE-mail: audycki@comcast.net

Dr. Audycki has no financial interest in the subject.