Comparison of a hydrogel corneal inlay and monovision laser in situ keratomileusis in presbyopic patients: focus on visual performance and optical quality

Verdoorn, Cornelis

doi:10.2147/opth.s142075

Cited by 6 publications

(4 citation statements)

References 27 publications

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“…In contrast, some of the older patients with decreased UNVA may struggle to adapt and accept the visual compromises inherent in presbyopia. This group also eventually need driving glasses and daily glasses, even after successful surgery due to declining visual function with age [27][28][29][30][31][32][33][34][35][36][37]. Older patients may also experience response shifts [20]; their SHS score was greater than that of the younger group at baseline, initially increasing, but then continuously decreasing until there was no difference with the younger group.…”

Section: Discussionmentioning

confidence: 99%

“…Numerous repeats have associated satisfaction with LASIK and age, complications, and uncorrected distance visual acuity (UDVA) [21][22][23][24]. We hypothesized that anisometropia could be another factor contributing to the decline of satisfaction and happiness that may happen in some patients due to ocular conditions, surgical complications, and intentional monovision for presbyopic LASIK [27][28][29][30]. Anisometropia after LASIK could be a significant issue, both in unexpected and expected cases.…”

Section: Introductionmentioning

confidence: 99%

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Subjective Happiness and Satisfaction in Postoperative Anisometropic Patients after Refractive Surgery for Myopia

Negishi

Toda

Ayaki

et al. 2020

JCM

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Laser-assisted in situ keratomileusis (LASIK) contributes to increased patient happiness one month after surgery; however, longer term effects are unknown. We performed a retrospective cross-sectional study on 472 patients who underwent bilateral LASIK surgery to measure happiness and satisfaction with LASIK, and to identify affecting factors. Patients completed questionnaires on satisfaction with the surgery and the subjective happiness scale (SHS) before, and 1, 3, 6, and 12 months after surgery. Multiple regression analyses were performed to determine independent predictors of SHS and satisfaction scores. Mean SHS increased at one month but was similar to baseline levels by six months. The SHS of older patients was greater than younger ones at baseline and at one and three months, while satisfaction among the older group was poorer at one and three months. Multiple regression analyses revealed that the decrease in SHS score from one month to three months correlated with baseline SHS, SHS at one month, uncorrected distance visual acuity (UDVA), and age. Regression analysis revealed SHS at six months correlated with preoperative SHS, SHS at one month, and satisfaction at six months. Satisfaction at final visit correlated with age, UDVA, anisometropia, and with SHS at each visit. We conclude that happiness and satisfaction were age- and UDVA-dependent, and anisometropic patients report poorer satisfaction scores.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Subjective Happiness and Satisfaction in Postoperative Anisometropic Patients after Refractive Surgery for Myopia

Negishi

Toda

Ayaki

et al. 2020

JCM

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“…Castro et al simulated the anisocoria generated by corneal inlays using a small aperture contact lens and demonstrated a significant deterioration of stereo-acuity for near and intermediate distances [ 13 ]. Also, studies with LASIK monovision demonstrated that in a proportion of these patients, stereo-acuity is lost and that once lost, it does not recover [ 11 , 14 , 15 ]. Our results were similar to those of Reinstein et al, who found that although postoperative uncorrected stereo-acuity was lower than preoperative near-corrected stereo-acuity after LBV, a functional level of stereo-acuity was maintained postoperatively; 68% of patients had stereo-acuity of 100 sec or better and 93% had stereo-acuity of 200 sec or better [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

Functional Outcomes and Reading Speeds following PRESBYOND LBV Using Nonlinear Aspheric Ablation Profiles Combined with Micro-Monovision

Brar

Sute

Bagare

et al. 2021

Journal of Ophthalmology

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Purpose. To report the functional outcomes and reading speeds following PRESBYOND laser blended vision (LBV) using nonlinear aspheric ablation profiles with micro-monovision with the Carl Zeiss Meditec MEL 90 platform. Methods. Data have been collected retrospectively for all patients who underwent PRESBYOND LBV using the MEL 90 excimer laser. Postoperative binocular uncorrected distance and near visual acuity, stereo-acuity, contrast sensitivity, and reading performance were compared with pre-op values measured with patient’s progressive glasses. Mean follow-up was 6 ± 1.2 months. Results. Sixty eyes of 30 patients (mean age 50.47 ± 6.43 years) were included. Of these, 18 patients were hyperopic and 12 patients were myopic with mean SE of 1.28 ± 1.38 D and −2.84 ± 1.86 D, respectively. At 6 months, the mean binocular UDVA was ≥−0.03 ± 0.06 log MAR and the mean binocular UNVA was ≥0.22 ± 0.04 log MAR. The uncorrected reading speeds (words per minute) at the preferred reading distance of 46.17 cm, 60 cm, and 80 cm were significantly better ( p value <0.01), whereas the smallest letter size and reading acuities were comparable to the preoperative values ( p > 0.05 for all distances). Uncorrected contrast sensitivity log values showed mild reduction; however, this was not statistically significant for any spatial frequency. There was a significant reduction in post uncorrected stereopsis to 89.67 arc sec, compared with pre-op corrected stereopsis (50.67 arc sec); however, it recovered fully with near correction (53.33 arc sec, p > 0.05 compared with pre). Conclusion. PRESBYOND LBV resulted in significantly better reading speeds and satisfactory functional visual outcomes, without a permanent change in stereo-acuity and contrast sensitivity 6 months postoperatively.

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“…Intracorneal refractive inlays have been used for the correction of presbyopia. 1–7 Among reported complications with their clinical use are infection, abnormal wound healing leading to corneal haze, dislocation, decentration, and keratolysis that may necessitate explantation. 8–11 In this report, we describe a serious vision-threatening complication after the implantation of a presbyopic inlay in combination with hyperopic laser in situ keratomileusis (LASIK).…”

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confidence: 99%

Presbyopic Corneal Inlay Extrusion Consequent to Sterile Keratolysis: Surgical Revision and Long-Term Management

Kanellopoulos

2022

Cornea

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The purpose of this study was to report a serious complication of early sterile keratolysis associated with a presbyopia inlay implantation combined with hyperopic laser in situ keratomileusis (LASIK).Methods: A 55-year-old hyperopic man underwent uneventful topography-guided bilateral femtosecond laser-assisted hyperopic LASIK, combined with same-day polymer refractive inlay implantation in the nondominant eye for additional presbyopia correction. Within 2 months, anterior sterile keratolysis and partial extrusion required surgical explantation of the inlay, and long-term medical management over 9 years achieved effective visual rehabilitation documented also with corneal imaging.Results: Immediate postoperative results were binocular 20/20 uncorrected distance visual acuity and J1 uncorrected near visual acuity. The early progressive anterior sterile keratolysis and partial extrusion necessitated surgical explantation at 2 months, severe anterior scarring of the perforated flap area and severe focal flattening of the cornea of over 10 diopters, developed despite aggressive topical corticosteroid use. The uncorrected distance visual acuity in the OS dropped from 20/ 25 to 20/400. The LASIK flap portion that underwent keratolysis and perforated, remodeled long-term from a scarred, epithelial plug with early significant surface concavity to evidently a mild subepithelial localized hazy area with regularized curvature over a period of 9 years.Conclusions: Some refractive synthetic corneal inlays have been recalled because they may result in significant corneal haze. We present herein a case of severe keratolysis that necessitated surgical explantation and further document long-term care for eventual visual rehabilitation.

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Comparison of a hydrogel corneal inlay and monovision laser in situ keratomileusis in presbyopic patients: focus on visual performance and optical quality

Cited by 6 publications

References 27 publications

Subjective Happiness and Satisfaction in Postoperative Anisometropic Patients after Refractive Surgery for Myopia

Subjective Happiness and Satisfaction in Postoperative Anisometropic Patients after Refractive Surgery for Myopia

Functional Outcomes and Reading Speeds following PRESBYOND LBV Using Nonlinear Aspheric Ablation Profiles Combined with Micro-Monovision

Presbyopic Corneal Inlay Extrusion Consequent to Sterile Keratolysis: Surgical Revision and Long-Term Management

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