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R. R. Krueger, R. Yeilding, R. Frey; Femtosecond Laser Treatment of the Crystalline Lens for Accommodation Restoration. Invest. Ophthalmol. Vis. Sci. 2010;51(13):810.
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© ARVO (1962-2015); The Authors (2016-present)
Femtosecond laser treatment of the crystalline lens for presbyopia has been studied using: 1) computer modelling, 2) porcine and human cadaver eyes, 3) living rabbits and monkeys. We seek to summarize the preclincal studies.
Computer modelling was based on sliding lens fibers and was modified by 20 concentric shells of femtosecond laser treatment. Ex-vivo cadaver lenses were rotated, stretched and compressed to evaluate the shape and mechanical changes before and after treatment. IACUC approval was gained by UCF(rabbits) and UofW (monkeys). Cataractogenesis of rabbits was studied for three months using photography and scanning laser scatter, while 3 aged Rhesus monkeys were evaluated for up to 2 years.
Compression studies reveal very repeatable reduction in lens stiffness (2X to 2.5X) in human cadaver lenses (ages 55 to 77 years) compared to controls. Intralenticular laser safety was assessed with scanning laser scatter measurements and found to be similar to untreated controls in rabbits. No cataract was found in any animal lens, but only faint pinpoint opacities. In monkeys, this persisted without cataract formation for 2 years. Histology showed clean photodisruption craters.
Femtosecond lasers show promise for reducing lens stiffness in preclinical studies. Living animal studies are supportive, with no cataract formation, but only faint pinpoint opacities. Further human studies using central sparing algorithms are planned for the future.
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