Objectives This study evaluated outcomes in eyes with retinal disorders with moderate to profound vision impairment after Excimer-Laser-Multiple-Light-Redirection (Excimer-MLR), a non-central, superficial and multifocal corneal photoablation for novel refractive neuroadaptive vision restoration. Methods Retrospective analysis of seven consecutively treated phakic and pseudophakic eyes followed for 18–24 months after unilateral Excimer-MLR. Results Control untreated fellow eyes: No significant change in median best-corrected distance visual acuity (BCDVA) or contrast sensitivity (CS). Treated eyes: Excimer-MLR temporarily modified corneal radii of curvature, defocused light at the PRL, decreased relative refractive error at multiple non-PRL retinal areas and shifted fixation. Median BCDVA improved significantly (p = 0.018) from baseline at all measured times between 3- and 24-months, with ≥15 ETDRS-letter-gain in 86% at 18–24 months. Preoperative mean and median BCDVA were 20/225 (range 20/100–20/604) and 0.98 logMAR, respectively. Mean BCDVA was 20/58, 20/68, 20/64, 20/60, mean (±SD) ETDRS-letter-gain was 28.9 (±10.6), 25.5 (±13.7), 26.8 (±14.9), 28.4 (±14.1) and median BCDVA was 0.40, 0.38, 0.48, 0.40 at 3, 6, 10–12, and 18–24 months, respectively. Median CS significantly improved from baseline. All treated eyes had preoperative-central scotomas that rapidly disappeared or became smaller and peripheral. Amsler grids were normal in 6/7 eyes at ≥18 months. Mean (±SD) retinal sensitivity average thresholds (RS) increased by 1.53 dB (±1.16) at 6 months. There were no changes in distance- or near-glasses and no Excimer-MLR-related adverse events. Conclusion Excimer-MLR, a rapid corneal procedure beneficially synergistic with retinal therapies, safely produced, without customisation, magnification or visual training, significant multiyear-visual improvements and increased retinal sensitivity in eyes with macular degeneration or surgically treated macular holes.

Background/Objectives: Myopia is a growing global problem. Current preventative treatments are inadequate, and myopia control spectacles intentionally degrade peripheral optical quality over large retinal areas. Variable results have been related to near-peripheral retinal refractive variability and chromatic refractive spread. A narrow paracentral band of collimating apertures created by annuli with plus-add surrounding appropriately small distance-correcting areas is proposed to decrease defocus and dynamic accommodation cues at the most responsive retinal area for controlling axial elongation while optimizing peripheral vision. Methods: Axial lengths (AL), with the contralateral myopic eye serving as the control, were measured in a child with masking after distance and near viewing with a stick-on placed coaxially on a single-vision (SV) spectacle lens during the AL diurnal cycle’s ascending phase only during the experimental sessions at myopia onset and two years later in a case study. The stick-on consisted of a 3.5 mm-wide annular +3D lens containing collimating apertures created by surrounding 1.5 mm-wide circular openings within the stick-on with plus power over the SV minus lens. Results: There was no elongation during near viewing in the child’s eye with the stick-on, while the contralateral control eye without the stick-on elongated. The expected increase in elongation during distance viewing during the child’s AL diurnal cycle’s ascending phase was reduced at age 8 and again at age 10 in the eye with the stick-on compared to the eye without the stick-on. Adaptation was immediate. Central and peripheral visual acuities were no different with or without the stick-on. Conclusions: This proof-of-concept study in a single child at myopia onset and two years later during myopia progression suggests the potential of this novel strategy for reducing short-term axial elongation during distance and near viewing. Stick-ons, clip-ons, electronic and non-electronic spectacles and contact lenses combining near-peripheral collimation with near-peripheral myopic defocus treatment at the narrow near-peripheral retinal area should be further explored for controlling myopia without reduction of peripheral vision.