Hydrogel intracorneal inlays for the correction of hyperopia: outcomes and complications after 5 years of follow-up.
OBJECTIVE
To evaluate safety and efficacy of an intracorneal inlay for the correction of hyperopia.


METHODS
A prospective, nonrandomized, noncomparative, 2-center study.


METHODS
Thirty-four hyperopic eyes were implanted with a hydrogel intracorneal inlay (Permavision, Anamed, Lake Forest, CA). Preoperative hyperopia was +3.9 diopter (D; range, +2 to +7). Uncorrected visual acuity (UCVA) was the logarithm of the minimum angle of resolution (logMAR; the decimal logarithm of decimal visual acuity with a minus sign) 0.6 +/- logMAR 1, and best-corrected visual acuity (BCVA) was logMAR 0.1 +/- 0.7.


METHODS
Corneal flaps were created with a mechanical microkeratome (M2 [Moria, Anthony, France] or Amadeus [Advanced Medical Optics Inc, Santa Ana, CA]; 180 microm), followed by inlay implantation onto the stromal bed over the pupillary center and covered by the corneal flap. Follow-up was 5 years.


METHODS
We measured UCVA and BCVA; patients underwent, slit-lamp examination, pachymetry, and confocal microscopy. The follow-up was up to 6 years.


RESULTS
The UCVA improved during 3 months and was stable for up to 2 years. There was a loss of > or =2 lines of spectacle-corrected visual acuity in 35% of eyes at 2 years, and a loss of > or =2 lines in 55.5% of the eyes at 5 years. Refractive predictability was poor, with 60% of the eyes having +/-3.00 D of emmetropia. A decentration of the inlay occurred in 29.4%, progressive perilenticular deposits were observed in 88.2%, haze was seen in 73.5%, and the inlay was explanted in 58.8%, with a cumulative survival rate of 58.4%.


CONCLUSIONS
An intracorneal inlay may be an option to treat hyperopia, but the tested inlay caused significant visual loss and scarring and had to be explanted in the majority of cases.
Mulet
M Emilia
ME
Department of Ophthalmology, Miguel Hernández University, Alicante, Spain.
Alio
Jorge L
JL
Knorz
Michael C
MC
D000328:Adult; D003319:Corneal Stroma / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D020136:Hydrogel, Polyethylene Glycol Dimethacrylate; D006956:Hyperopia / Q000601:surgery*; D007431:Intraoperative Complications; D018613:Microscopy, Confocal; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D019736:Prostheses and Implants; D019919:Prosthesis Implantation; D054140:Refractive Surgical Procedures / Q000379:methods*; D013524:Surgical Flaps; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology
D020136:Hydrogel, Polyethylene Glycol Dimethacrylate