EyeWorld Asia-Pacific June 2016 Issue

June 2016 46 EWAP refractive Future of noninvasive presbyopia treatment by Liz Hillman EyeWorld Staff Writer New generation of nonsurgical presbyopia options show promise, but will they make it to market? W hile there are many options for presbyopia management, patients eager to give up glasses might not be willing to take the plunge into surgical correction. Currently, work is being done to fill that void with many possible noninvasive solutions. From drops to electrostimulation, there is a growing body of research on new methods to help the lens accommodate, but are they safe? Are there side effects? And do they actually work? Although these questions—and more—in many cases have yet to be answered by peer-reviewed, scientific research, John Berdahl, MD , Vance Thompson Vision, Sioux Falls, South Dakota, thinks the future of noninvasive presbyopia treatments looks bright. “Everyone gets presbyopia and no one likes it,” he said. “In general, no one wants surgery, but people do want to see, so they’re willing to undergo surgery as Dr. Gualdi performs micro-electrostimulation treatment of the ciliary body on a patient with presbyopia. Source (all): Luca Gualdi, MD long as it is safe, effective, and improves their quality of life. But I think that most people would prefer a nonsurgical option if it was easy and convenient and worked. Nonsurgical options have yet to show that they’re easy, convenient, and work, but they certainly have that promise.” Presbyopia-correcting drop L. Felipe Vejarano, MD , Popayán, Colombia, admits that his invention—a drop formula that provides dynamic pseudoaccommodation by stimulating the ciliary muscle— might sound “unbelievable.” The physician with a pharmacological background created the drop to use on himself more than 5 years ago. Currently called PresbV Tears, the drop contains a patent-pending mix of FDA-approved substances that he said allow the pupil to go from 2.5 mm to 4 mm (depending on light conditions). One drop, he said, lasts 4–5 hours with the effect starting 15–30 minutes after its application. Dr. Vejarano presented at the American Academy of Ophthalmology’s Refractive Surgery 2015 Subspecialty Day on research involving the drop that Micro-electrostimulation is one nonsurgical option that could be used to correct presbyopia. A scleral contact lens with electrodes delivers low-voltage pulses to the ciliary body to “exercise” the muscle and temporarily improve its ability to accommodate