Presbia — Technical Presentation (May 2016)
14 slides from Presbia's technical presentation, May 2016
Slide 1: Decentration Effect on Presbia Microlens
Decentration Effect on Presbia Microlens Acuity endpoint analysis ISOP Copenhagen 2016 Wayne Crewe-Brown, MD Caution: Investigational Device. Limited by Federal (or United States) law to investigational use.
Slide 2: Overview
Overview Purpose Determine effect on visual acuity of degrees of decentration from visual axis Study Design Retrospective observational analysis Method Deviation from ideal centration of the Presbia Microlens measured on the iTrace Ray Tracing aberometer (www.traceytechnologies.com) Co
Slide 3: Demographics
Demographics 122 patients with Presbia Microlens implanted in non- dominant eye in a commercial laser refractive clinic Male: 59 Female: 63 Emmetropic Presbyopes: 51 Concurrent LASIK procedure: 69 Caution: Investigational Device. Limited by Federal (or United States) law to investigational u
Slide 4: Presbia Microlens
Presbia Microlens Hydrophilic polymer material Implanted in the cornea 0.5mm hole in the center of the disc that permits the transfer of oxygen and nutrients† †Larrea X, De Courten C, Feingold V, Burger J, Büchler P. Oxygen and glucose distribution after intracorneal lens implantation. Optom V
Slide 5: Ideal Implantation Position
Ideal Implantation Position Presbia Microlens is placed in a corneal stomal pocket 300um from the epithelium Centered on the 1st Purkinje Patient fixating on target on Laser platform (here the Visx S4 IR, AMO) 1st Purkinje reflex viewed through coaxial microscope Caution: Investigational D
Slide 6: iTrace Centration
iTrace Centration Presbia Microlens in-situ iTrace measurements Caution: Investigational Device. Limited by Federal (or United States) law to investigational use.
Slide 7: Key Endpoints
Key Endpoints • UCDVA: Uncorrected Distance acuity • BCDVA: Best corrected Distance acuity • UCNA: Uncorrected Near acuity • Decentration from visual axis (P1) in microns Caution: Investigational Device. Limited by Federal (or United States) law to investigational use.
Slide 8: Acuities Summary
Acuities Summary Means (logMAR) Wilcox Ranked Sum Paired pValues UCDVA BCDVA UCNVA UCDVA BCDVA UCNVA 1m vs. 3m 0.262 0.112 0.429 PreOp 0.205 -0.054 0.777 Column1 UCDVA BCDVA UCNVA 1 Month 0.450 0.208 0.402 LASIK vs. Pocket 0.139 0.638 0.798 3 Month 0.420 0.164 0.378 only Paired Wilcox Ranked sum tes
Slide 9: Methodology
Methodology Statistical analysis of the acuity outcomes for all three endpoints revealed no significant difference between the 1 and 3 month intervals Accordingly the 3 month outcomes were used for post-op correlation to decentration Decentration was measured on the iTrace unit Decentration
Slide 10: Acuities by Decentration
Acuities by Decentration Categories: • A= less than 100um • B= 100-200um • C= 200-300um • D= 300-400um • E= 400-500um • F= 500+ Caution: Investigational Device. Limited by Federal (or United States) law to investigational use.
Slide 11: Multiple Regression Plots
Multiple Regression Plots • Acuity endpoints vs. decentration group • All 3 Regression lines flat or negative Caution: Investigational Device. Limited by Federal (or United States) law to investigational use.
Slide 12: Correlation Tests
Correlation Tests UCDVA BCDVA UCNVA p.value 0.836 0.0683 0.741 UCDVA BCDVA UCNVA rho 0.021 -0.196 0.034 • Spearman Rho Correlation (multiple regression analysis) shows no statistical significance (p>0.05) in all endpoints • Indicating no correlation between magnitude of decentration and acuity endpo
Slide 13: Discussion
Discussion The lack of correlation between the acuity endpoints at both distance and near to decentration is surprising Possible reasons for this presentation are the skew of the decentration values towards the lower magnitudes. The source of the data too, needs consideration. All outcomes wer
Slide 14: Summary
Summary From this review it appears the Presbia Microlens is not overly sensitive to small errors in centration The variability and range of outcomes presented in a commercial setting likely explained by: Patient adaptive factors 20/Happy refraction culture in commercial setting A more con