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Corneal Filler Injection for Correction of Refractive Error in-vivo

Applicant Dr. Lara Buhl
Subject Area Ophthalmology
Term from 2023 to 2024
Project identifier Deutsche Forschungsgemeinschaft (DFG) - Project number 520479593
 
Final Report Year 2024

Final Report Abstract

Refractive error is the incapacity to accurately focus light onto the retina, creating a blurred image. It is a major cause of reversible visual impairment worldwide, with profound social and economic implications across all ages. The most common refractive error types are farsightedness (hyperopia), nearsightedness (myopia), astigmatism, and presbyopia. Possible treatment options are glasses, contact lenses, or laser refractive surgery. Current corneal laser refractive surgery alters the cornea's refractive power by ablating corneal tissue. It is considered safe and effective, especially for myopia correction. However, for hyperopia and presbyopia correction, the refractive results are less predictable and regress over time. Additionally, the central corneal portion increased in refractive power by the tissue ablation is small resulting in enhanced optic aberrations as the light is bended differently especially at night. Therefore, we previously proposed to correct hyperopia and presbyopia by injecting viscous, transparent filler material into a femtosecond-laser-created corneal pocket to steepen the corneal curvature. Fine-tuning the refractive correction is possible by subsequent addition or removal of filler material. In the past, additive procedures have proven to be less predictable than laser-based tissue ablation. In addition, reduced tissue compatibility of the implant material was a concern. This may be due to direct toxicity and limited permeability of the material, which may hinder nutrient diffusion across the cornea. Therefore, a procedure is needed that allows (1) fine-tuning of the refractive result to reduce the prediction error, as well as (2) a material that is tissue-compatible and has refractive properties similar to the cornea. Therefore, this project aimed to test a novel filler material in vivo for their stability and tissue compatibility. The knowledge gained may provide a better understanding of the requirements for such a material and is the next step towards the clinical application of this procedure.

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