Prospective evaluation of PermaVision intracorneal implants using in vivo confocal microscopy.
OBJECTIVE
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 microm vs 48 +/- 8 microm, 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.
Lindsey
Sara S
SS
Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas, USA.
McCulley
James P
JP
Cavanagh
H Dwight
HD
Verity
Steven M
SM
Bowman
R Wayne
RW
Petroll
W Matthew
WM
D002452:Cell Count; D003315:Cornea / Q000473:pathology / Q000503:physiopathology; D003319:Corneal Stroma / Q000473:pathology; D019573:Epithelium, Corneal / Q000473:pathology; D006801:Humans; D006956:Hyperopia / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D007634:Keratitis / Q000209:etiology / Q000473:pathology; D019654:Lens Implantation, Intraocular / Q000009:adverse effects; D007910:Lenses, Intraocular / Q000592:standards*; D018613:Microscopy, Confocal; D011446:Prospective Studies; D013524:Surgical Flaps / Q000009:adverse effects; D013997:Time Factors; D014792:Visual Acuity