New presbyopia surgery a real pearler

A new technique to improve near vision in presbyopic patients harnesses human corneal tissue

25 Oct 2016 by Olivia Wannan

The latest in corrective surgery for myopes is now also helping presbyopes to read more easily, through a new technique, PrEsbyopic Allogeneic Refractive Lenticule or PEARL for short.

The procedure, which has been trialled in six patients, was pioneered by researchers at Dr Agarwal’s Group of Eye Hospitals in India and presented at AAO 2016 (14–18 October, Chicago).

The technique utilises the tissue left over from SMall Incision Lenticule Extraction (SMILE) surgery, the procedure’s creator, Dr Soosan Jacob, told OT.

In SMILE surgeries on myopic patients, the lenticule is removed completely, but in PEARL, the lenticule from these patients is taken and then cut to 1mm and reshaped using precision femtosecond lasers.

This tissue is then surgically placed into a “pocket in the cornea” of a presbyopic patient to improve their reading vision, without compromising their distance vision.

Previously, surgeries to improve the near vision of presbyopic patients used tiny, artificial lenses or devices inserted into the cornea to improve reading vision. However, the body can reject these synthetic inserts.

Dr Jacob and her team hope that using human tissue will overcome this problem. Of the six patients who underwent the procedure, all showed improvements in their near vision, as measured with the Jaegar Eye Chart. The patients’ vision also remained stable during the four months they were monitored after the surgery.

Dr Jacob highlighted that: “Because it’s made of human corneal tissue, the inlay remains stable. Our preliminary findings have been very promising.”

Image credit: Surian Soosay


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    I don't see how it is possible to do this without compromising distance vision. It must introduce some blur and aberrations that will affect the quality of vision with at least a reduction in contrast, and probably halos at night, even if acuity is not significantly reduced. There is no magic cure for presbyopia.

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