Correction of hyperopia by intracorneal lenses: two-year follow-up.
OBJECTIVE
To assess the safety and efficacy of intracorneal lenses as a surgical alternative for the correction of hyperopia.


METHODS
Al-Azhar University and El Magrabi Eye Hospital, Cairo, Egypt.


METHODS
Twenty-three eyes of 21 patients who had a mean hyperopia of 4.3 diopters (D) +/- 0.71 (SD) (range +2.5 to +6.0 D) received Permavision lenses (Anamed Inc.), which are made of a highly permeable hydrogel with a water content of 78% and a refractive index close to that of corneal tissue (1.376). The Moria M2 microkeratome was used to make a 160 microm corneal flap with a diameter of +/-8.5 mm. The intracorneal lens was placed beneath the flap after minimal interface irrigation.


RESULTS
Clinical examination showed mild corneal edema and a myopic shift during the first week postoperatively. In 17 eyes (73.9%), the postoperative uncorrected visual acuity was similar to the preoperative best corrected visual acuity (BCVA); 1 eye (4.3%) lost 1 line of preoperative BCVA. In 5 eyes (21.7%), various degrees of lens opacification with some degree of corneal haze were seen after uneventful follow-up. Decentration of 0.5 to 1.0 mm was seen in 2 eyes (8.6%), 1 of which had the lens explanted because of significant opacification. Induced astigmatism was evident in 1 eye (-1.5 D). A total of 16 eyes (69.6%) were within +/-0.5 D of target, and 20 eyes (86.9%) were within +/-1.0 D (87%). No flap melting or extrusion of the lens was recorded in 24 months of follow-up. Night halos and glare were reported in 3 eyes; all had a lens diameter of 5.0 mm.


CONCLUSIONS
Intracorneal hydrogel lenses were tolerated relatively well by stromal tissue, providing a reasonably stable and predictable way to correct moderate hyperopia. However, induced astigmatism, stromal opacification, decentration, and night halos and glare occurred in a significant number of eyes. To ensure safety, deep flap cuts are preferred and these eyes should be watched carefully to avoid decentration of the lens in the early postoperative period.
Ismail
Mahmoud M
MM
University of Al-Azhar and Chief Cornea El Magrabi Hospital, Cairo, Egypt. mahmoud.ismail@magrabi.com
D000328:Adult; D003319:Corneal Stroma / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006956:Hyperopia / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011102:Polyhydroxyethyl Methacrylate; D011183:Postoperative Complications; D019736:Prostheses and Implants; D019919:Prosthesis Implantation; D013524:Surgical Flaps; D014792:Visual Acuity
D011102:Polyhydroxyethyl Methacrylate