Theranostic-Guided UV-A Light Corneal Wavefront Photo-Reshaping for Presbyopia Correction: A Preclinical Study

This study investigated the effect of a theranostic-guided UV-A light corneal photo-reshaping technique on corneal elevation and wavefront aberration (WA) in human donor eyes. A specialized platform, combining UV-A light with corneal iontophoresis for controlled, patterned, riboflavin delivery, was used for both distribution assessment and concentration-driven photopolymerization of corneal proteins. In all cases, a consistent riboflavin concentration gradient, with lower levels in the central prepupillary zone, was recorded. Corneal topography and WA measurements showed significant corneal steepening and smooth wavefront shaping, respectively, with a delay in the central 2.0 mm of the WA and advancement in the surrounding zone, as well as a 50% reduction in corneal spherical aberration over a 5.0 mm pupil size. Notably, the corneal optical quality, measured via modulation transfer function (MTF), remained stable. This incision-free approach demonstrated the potential to extend focal range without compromising distance vision, presenting a new solution for presbyopia correction.