Long-term outcomes after monocular corneal inlay implantation for the surgical compensation of presbyopia

Dexl, Alois K.; Jell, Gerlinde; Strohmaier, Clemens; Seyeddain, Orang; Riha, Wolfgang; Rückl, Theresa; Bachernegg, Alexander; Grabner, Günther

doi:10.1016/j.jcrs.2014.05.051

Cited by 74 publications

(62 citation statements)

References 16 publications

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“…Patient satisfaction after KAMRA inlay has been evaluated by several studies and has been shown to be good 7,9,11,17. Patient satisfaction from the FDA clinical trials was not reported.…”

Section: Discussionmentioning

confidence: 99%

Six-month visual outcomes for the correction of presbyopia using a small-aperture corneal inlay: single-site experience

Moshirfar¹,

Quist²,

Skanchy³

et al. 2016

OPTH

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ObjectiveThe objective of this study was to describe 6-month postoperative efficacy and safety outcomes after monocular KAMRA corneal inlay implantation in emmetropic presbyopic patients.Study designThis study followed a retrospective chart analysis.SettingThis study was performed at Hoopes Vision in Draper, UT, USA.Subjects and methodsFifty-seven patients met the inclusion criteria of this study and underwent KAMRA corneal inlay implantation following the approval of the United States Food and Drug Association between May 2015 and April 2016 at a single site. Surgery involved femtosecond laser-created corneal pockets of various depths. Efficacy, safety, and patient satisfaction reports were analyzed at 3 and 6 months.ResultsAt 6 months follow-up, the monocular uncorrected near visual acuity (UNVA) was Jaeger (J) 4 (20/32), the mean uncorrected distance visual acuity was 20/25, and the mean corrected distance visual acuity was 20/20. At 6 months, 71% of patients with a pocket depth of ≥250 μm had a UNVA of 20/20 or better, whereas only 22% of patients with a shallow pocket depth of <250 μm had a UNVA of 20/20 or better. There was no statistical difference in UNVA at 6 months between virgin eyes and post-LASIK eyes. One patient had an explant and five patients underwent inlay recentration, all of which resulted in improved visual acuity. At 6 months, 72% of patients reported some level of satisfaction, 26% of patients reported being “not dependent” on reading glasses, and 62% of patients reported being able to do most things in bright light without reading glasses.ConclusionFor patients with emmetropic presbyopia, the KAMRA inlay is a viable treatment option resulting in improved UNVA. Increased pocket depth may be associated with better postoperative outcomes. Safety rates are high, while explantation and recentering rates are low. Overall, patient satisfaction of the KAMRA inlay is good.

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“…Patient satisfaction after KAMRA inlay has been evaluated by several studies and has been shown to be good 7,9,11,17. Patient satisfaction from the FDA clinical trials was not reported.…”

Section: Discussionmentioning

confidence: 99%

Six-month visual outcomes for the correction of presbyopia using a small-aperture corneal inlay: single-site experience

Moshirfar¹,

Quist²,

Skanchy³

et al. 2016

OPTH

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“…19,26 The explantation rate in cases of visual dissatisfaction varies widely across series from 0% to 21%. 14,22,[27][28][29] One study concluded that after removal, corneal topography and aberrometry were not permanently affected with a return to preoperative corrected and uncorrected vision in the majority of cases. 30 Advances in the biocompatibility of materials and designs allowing for improved metabolic regulation have made modern inlays much safer than their precursors.…”

Section: ' Postoperative Complicationsmentioning

confidence: 99%

“…36 Even 6 months after initial placement, successful recentration has been reported. 19,26,29 Epithelial ingrowth can rarely occur after corneal inlay placement. Authors have described the successful treatment of ingrowth by lifting the flap, meticulous removal of the ingrowth, and placement a nylon suture at flap margin, similar to the treatment of ingrowth after LASIK.…”

Section: ' Postoperative Complicationsmentioning

confidence: 99%

“…Authors have described the successful treatment of ingrowth by lifting the flap, meticulous removal of the ingrowth, and placement a nylon suture at flap margin, similar to the treatment of ingrowth after LASIK. 29 A few other cases of epithelial ingrowth have been reported, but were resolved or did not affect the visual axis. 19,32 The rate of infectious keratitis after inlay implantation has not been well described, but it seems to be low.…”

Section: ' Postoperative Complicationsmentioning

confidence: 99%

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Complications of Intracorneal Implants in Refractive Surgery

Hood

2016

International Ophthalmology Clinics

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In refractive surgery, the use of intracorneal implants, including intracorneal ring segments (ICRS) and corneal inlays, offer the specific advantage of not removing corneal tissue. As such, they are removable and may preserve options for ametropia or presbyopia correction with current or future modalities. 1,2 However, there are unique intraoperative and postoperative complications that can occur with their implantation that need to be recognized and managed. The following review will focus on the incidence and management of complications from the use of intracorneal implants in refractive surgery. ' ICRS for Correction of MyopiaICRS are polymethylmethacrylate segments implanted in the deep corneal stroma to modify the corneal curvature based on their geometric profile and diameter. Although initially approved for low myopia in the United States in 1999, 2 the technology was soon after used for the treatment of keratoconus. 3 The creation of channels for the placement of ICRS can be performed either mechanically using semicircular dissectors or with a femtosecond laser. Although the femtosecond laser creates channels with a high degree of precision, no published studies have demonstrated higher complications or inferior refractive outcomes for myopia with mechanical channel creation. For the treatment of myopia, ICRS offer the advantage over ablational laser refractive surgery of sparing the visual axis with very low risk of central corneal haze or scarring, and the effects may be reversible with removal of the segments. 2,4,5 Although corneal excimer laser refractive surgery has largely replaced the use of ICRS for myopia due to the excellent outcomes, there may still be a role for ICRS for the treatment of low

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“…Also, the postoperative distance visual acuity is not influenced by the pupil size [12] of the patient after KAMRA inlay implantation. There are also long-term studies [13][14][15] that show a significant increase of visual acuity in intermediate and near vision [16], but with a slight decrease in distance vision, in the eye that the inlay is implanted. However, binocular distance vision and stereopsis do not seem to be affected by the procedure [16].…”

Section: Introductionmentioning

confidence: 99%

KAMRA corneal inlay for the correction of presbyopia

Mallias

Mylova²,

Tassiopoulou³

et al. 2017

Ophthalmology J

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This is a case report of two patients who underwent presbyopia correction with KAMRA corneal inlay (KAMRA; AcuFocus, Irvine, CA) combined with LASIK surgery. The surgical technique is thoroughly explained, as well as the advantages and disadvantages of the procedure. In both patients, near uncorrected visual acuity significantly improved and distance uncorrected visual acuity remained unchanged. There were no changes in the corneal topography after the corneal inlay implantation.

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Long-term outcomes after monocular corneal inlay implantation for the surgical compensation of presbyopia

Abstract: Dr. Grabner was reimbursed for travel expenses from Acufocus. Dr. Riha is a consultant to Acufocus. No other author has a financial or proprietary interest in any material or method mentioned.

Cited by 74 publications

References 16 publications

Six-month visual outcomes for the correction of presbyopia using a small-aperture corneal inlay: single-site experience

Six-month visual outcomes for the correction of presbyopia using a small-aperture corneal inlay: single-site experience

Complications of Intracorneal Implants in Refractive Surgery

KAMRA corneal inlay for the correction of presbyopia

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