Understand the Patients’ Attitude towards Presbyopia and the various Lenses Correction Options

Aim: To reveal the patients point of view about the selection of different presbyopic correction options from ophthalmic lenses and awareness about presbyopia. Methodology: In this Prospective study, feedback questionnaire based study in North India, 126 subjects were enrolled and the offline questionnaire and responses were recorded. Participants’ age ranged between 37 -75 years (using near correction). Evaluated the responses to know the reasons of chosen of different options for pre-presbyopia and presbyopia correction by the subjects and attitudes about it, its importance, and present conventional correction opinions including bifocals, progressive addition lenses and contact lenses. Result: Among the all participants, number of participants between the age group 37- 45 (pre-presbyopes) were 35 (27.77%), between 45-55 years of aged group were 60 (47.61%) participants and rest of 31 (24.60%) participants were between 55-75 years of aged group. Forty eight participants (38.1%) were already wearing a near correction while seventy eight (61.9%) were not wear any near correction. Out of 126, the 6 (4.76%) subjects were chosen a near visual correction and separated glasses, 88 (69.84%) subjects were chosen the bifocal lenses, rest of all 32 (25.89%) subjects chosen the PALs. And no one was using contact lens for near correction. Few similarities were observed as age–related (75.38%), total unaware of word presbyopia (85.71%), comfort, convenience and appearance concerned (63%). Conclusion: The spectacles were most preferred for the correction of presbyopia. Bifocals are taken by majority of population. After educating about Presbyopia and advantages of PALs, it was revealed that most of the subjects wanted to choose PALs because of comfort and convenience to see all distances but most of them denied due to cost and 4-8 days adaptation time. So most of the subjects were chosen the bifocal lenses even they knew the disadvantages of it like image jump and segment line, while comfort, convenience and cosmetic appearance were seen as the preferred than cost. But cost also played role while finalize the lens and its coatings types.

Clinical performance of presbyopia correction with a multifocal corneoscleral lens

AIM: To assess the clinical performance of a multifocal corneoscleral lens for the presbyopia correction. METHODS: A prospective clinical trial of the Onefit™ A multifocal corneoscleral lens was conducted with 40 participants with presbyopia. At 4wk of continuous wear of the corneoscleral lens, changes in the distance, intermediate, and near visual acuity (VA) were evaluated. The safety of the corneoscleral lens, central corneal thickness (CCT), corneal endothelial cell count, binocular stereopsis, tear film break-up time (BUT), corneal staining, corneal edema, corneal neovascularization (NV), and conjunctival hyperemia were examined. In addition, a subjective questionnaire addressing satisfaction (rated from 1 to 5 points) and discomfort (rated from 1 to 5 points) was administered. RESULTS: Forty participants were enrolled in this study. Six participants were excluded because of poor compliance with lens fitting (n=2) and loss to follow-up (n=4). The mean age of the participants was 53.0±4.9y. At 4wk of continuous wear of the corneoscleral lens, the best corrected far, intermediate, and near VA was 0.08±0.11, 0.10±0.12, and 0.10±0.12 logMAR, respectively. These results were significant improvements over the baseline uncorrected VA (far: P=0.004; intermediate: P=0.004; near: P=0.002). CCT, corneal endothelial cell count, binocular stereopsis, BUT, corneal staining, corneal edema, corneal NV, and conjunctival hyperemia were not significantly different between baseline and after corneoscleral lens use. The average satisfaction scores for fit sensation; corrected far, intermediate, and near VA; and ease of handling were 4.1, 3.4, 3.6, 3.5, and 3.4, respectively. The average discomfort scores for dryness, irritation, foreign body sensation, redness, fogging, and halo were 1.7, 1.8, 1.5, 1.7, 1.7, and 1.3, respectively. CONCLUSION: Far, intermediate, and near VA are improved in presbyopic patients with the multifocal corneoscleral lens compared to uncorrected baseline VA, without adverse ocular effects. This evidence supports the safety and effectiveness of presbyopia correction with multifocal corneoscleral lenses.

Author Correction: Portable device for presbyopia correction with optoelectronic lenses driven by pupil response

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

Femtosecond Laser-assisted Lens Surgery with Low-energy Pulse versus Conventional Phacoemulsification for Presbyopia Correction: An Intraindividual Study

Background: Lens surgery with multifocal IOL implantation for presbyopia correction is performed by femtosecond laser-assisted lens surgery or conventional phacoemulsification. Objective: To compare the clinical results of femtosecond laser-assisted with low-energy pulse conventional phacoemulsification lens surgery for presbyopia correction intraindividually. Methods: Charts from patients who underwent Refractive Lens Exchange (RLE) for presbyopia correction in a single center, with Femtosecond Laser-Assisted Lens Surgery (FLALS) in one eye and Conventional Phacoemulsification (CP) in the other, were retrospectively reviewed. All eyes had the same multifocal Intraocular Lens (IOL) implanted. The clinical outcomes and the results of the level of satisfaction questionnaire were compared between the two groups according to the technique employed (FLALS vs. CP) for a period of up to four years. Stability, efficacy and safety indices were also assessed. Results: This study comprised a total of 56 eyes of 28 patients randomly assigned FLALS in one eye and CP in the other. No statistically significant difference was observed between the two techniques regarding postoperative visual acuities, duration of surgical procedure, efficacy or safety indexes (p>0.05). Refraction was stable in all FLALS eyes, whereas a change occurred in 2 eyes (7.1%) operated with CP upon 6 months postoperatively, but without statistical significance (p˃0.05). Satisfaction was slightly better with FLALS but not statistically significant (p=0.134). No immediate myosis or other adverse events after the femtosecond laser were registered. Conclusion: The parameters assessed showed no significant differences between the two techniques, in spite of a difference of refraction stability upon 6 months postoperatively.

Portable device for presbyopia correction with optoelectronic lenses driven by pupil response

A novel portable device has been developed and built to dynamically, and automatically, correct presbyopia by means of a couple of opto-electronics lenses driven by pupil tracking. The system is completely portable providing with a high range of defocus correction up to 10 D. The glasses are controlled and powered by a smartphone. To achieve a truly real-time response, image processing algorithms have been implemented in OpenCL and ran on the GPU of the smartphone. To validate the system, different visual experiments were carried out in presbyopic subjects. Visual acuity was maintained nearly constant for a range of distances from 5 m to 20 cm.