Prospective Evaluation of PermaVision Intracorneal Implants Using In Vivo Confocal Microscopy

Abstract

PURPOSE: To report effects of the PermaVision intracorneal lens at the cellular level using in vivo confocal microscopy. METHODS: Four eyes implanted with intracorneal lenses beneath an IntraLase flap for correction of hyperopia were evaluated preoperatively and 1 to 6 months postoperatively. RESULTS: Intracorneal lenses were tolerated in three eyes with little or no haze observed clinically and good visual results. Minimal keratocyte activation was detected by confocal microscopy, and cell density was decreased posterior to the implants. Epithelial thinning was observed 1 month after implantation. Thickness stabilized by 6 months but remained thinner than baseline (33±2 µm vs 48±8 µm, P<.01). The fourth eye had a complicated course with early flap displacement followed by diffuse lamellar keratitis. Confocal microscopy revealed activated keratocytes throughout the anterior stroma. The implant was removed, and recovery was promising. CONCLUSIONS: Implantation of intracorneal lenses can induce side effects of epithelial thinning, keratocyte loss, and keratocyte activation. [J Refract Surg. 2007;23:410-413.]

Morphologic study of the cornea by in vivo confocal microscopy and optical coherence tomography after bifocal refractive corneal inlay implantation

“…3 Another study confirmed that a thicker flap minimizes postoperative flap complications 28 ; shallow placement, as seen with Permavision (Anamed) intracorneal implantation, induced epithelial thinning, keratocyte loss, and keratocyte activation when flaps between 110 mm and 180 mm were used. 29 In our study, corneal pockets were between 280 mm and 300 mm, which is thicker than the 170 mm used in previous studies; no melting, stromal thinning, or other flap-related complications were reported. The change in the mean CCT from preoperatively to postoperatively was not significant, providing further evidence that the inlay did not alter the overall structure of the cornea.…”

Simultaneous corneal inlay implantation and laser in situ keratomileusis for presbyopia in patients with hyperopia, myopia, or emmetropia: Six-month results

“…Results in an earlier study 28 showed that a thicker flap (R180 mm) should be used to avoid flap complications and significant opacification. Another study 29 found that Permavision intracorneal implantation induced epithelial thinning, keratocyte loss, and keratocyte activation when a flap between 110 mm and 180 mm was used. Creating a 200 mm flap may decrease the amount of surface curvature change, which can lead to sequelae.…”

Μελέτη της ασφάλειας και αποτελεσματικότητας του ενδοκερατοειδικού διαθλαστικού ενθέματος Flexivue TM Micro-Lens (Presbia, CA Cooperatief U. A, Netherlands) για τη διόρθωση της πρεσβυωπίας

“…Εν συνεχεία, ο κρημνός επανερχόταν στην αρχική του θέση. Φακός κυρτού σχήματος χρησιμοποιούνταν για τη διόρθωση της υπερμετρωπίας, ο οποίος ενίσχυε την κυρτότητα του κερατοειδούς77,78,79,80 . Οι Mulet, Alio et al αναφέρουν μετεγχειρητική παρακολούθηση των ασθενών ίση με 6 χρόνια μετά από την εμφύτευση του ενθέματος αυτού σε 34 υπερμετρωπικούς ασθενείς.…”