title: Small-aperture corneal inlay implantation to treat presbyopia after laser in situ keratomileusis.
abstract: OBJECTIVE
  To evaluate the visual outcomes after implantation of a Kamra small-aperture corneal inlay into a femtosecond-created corneal pocket to treat presbyopia in patients who had previous laser in situ keratomileusis (LASIK).
  
  
  METHODS
  Private center, Tokyo, Japan.
  
  
  METHODS
  Prospective interventional case series.
  
  
  METHODS
  Post-LASIK presbyopic patients had inlay implantation into a corneal pocket created by a femtosecond laser at a depth of 200 μm or 250 μm a minimum of 80 μm below the previous LASIK flap interface in the nondominant eye. Uncorrected and corrected distance visual acuities, near visual acuity, and a patient questionnaire on satisfaction, the use of reading glasses, and visual symptoms were evaluated.
  
  
  RESULTS
  The study enrolled 223 eyes (223 patients) with a mean age of 53.6 years (range 44 to 65 years) and a mean manifest spherical equivalent of -0.18 diopter (D) (range -1.00 to +0.50 D). The mean uncorrected distance visual acuity in the operated eye decreased 1 line from 20/16 preoperatively to 20/20 6 months postoperatively (P<.001). The mean uncorrected near visual acuity improved 4 lines from Jaeger (J) 8 to J2 (P<.001). At 6 months, significant improvements were observed in patient dependence on reading glasses and patient satisfaction with vision without reading glasses.
  
  
  CONCLUSIONS
  The 6-month results suggest that implantation of a small-aperture inlay in post-LASIK presbyopic patients improves near vision with a minimal effect on distance vision, resulting in high patient satisfaction and less dependence on reading glasses.
  
  
  BACKGROUND
  Drs. Tomita and Waring are consultants to Acufocus, Inc. Dr. Tomita is a consultant to Ziemer Group AG. No other author has a financial or proprietary interest in any material or method mentioned.
authors.affiliation: Shinagawa LASIK Center, Tokyo, Japan. tomita@shinagawa-lasik.com
authors.forename: Minoru
authors.initials: M
authors.lastname: Tomita
authors.forename: Tomomi
authors.initials: T
authors.lastname: Kanamori
authors.forename: George O
authors.initials: GO
authors.lastname: Waring
authors.forename: Toru
authors.initials: T
authors.lastname: Nakamura
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yukawa
mesh_terms: D000328:Adult; D000368:Aged; D003319:Corneal Stroma / Q000601:surgery*; D023882:Dominance, Ocular; D005260:Female; D006801:Humans; D020731:Keratomileusis, Laser In Situ; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011145:Polyvinyls; D011182:Postoperative Care; D011305:Presbyopia / Q000601:surgery*; D011446:Prospective Studies; D019736:Prostheses and Implants; D019919:Prosthesis Implantation; D013524:Surgical Flaps; D011795:Surveys and Questionnaires; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology; D005465:Fluorocarbon Polymers
chemical_list: D011145:Polyvinyls; C024865:polyvinylidene fluoride; D005465:Fluorocarbon Polymers