Long-term outcomes after monocular corneal inlay implantation for the surgical compensation of presbyopia.
OBJECTIVE
To evaluate long-term outcomes of small-aperture corneal inlay implantation for the surgical compensation of presbyopia.


METHODS
Paracelsus Medical University, Salzburg, Austria.


METHODS
Prospective interventional cohort study.


METHODS
Monocular implantation of a Kamra small-aperture inlay (model ACI7000) (1.6 mm central aperture) was performed in emmetropic presbyopic eyes. The preoperative and postoperative parameters included monocular and binocular uncorrected (UDVA) and corrected (CDVA) distance visual acuities, uncorrected intermediate visual acuity (UIVA), and uncorrected (UNVA) and corrected (CNVA) near visual acuities; refraction; patient satisfaction; and complications.


RESULTS
From September 4, 2006, to May 21, 2007, a small-aperture inlay (1.6 mm central aperture) was implanted in 32 emmetropic presbyopic eyes. The mean binocular uncorrected visual acuities improved as follows: UNVA from Jaeger (J) 6 ± 1.2 lines (∼20/50) to J2 ± 1.8 lines (∼20/25) (P < .001) and UIVA from 0.2 logMAR ± 1.3 lines (∼20/32) to 0.1 logMAR ± 1.3 lines (∼20/25) (P = .04). The UDVA decreased from -0.2 logMAR ± 0.2 lines (∼20/12.5) to -0.1 logMAR ± 0.6 lines (∼20/16) (P < .001). At 60 months, 74.2% of patients had a UNVA of J3 (∼20/32) or better, 87.1% had a UIVA of 0.2 logMAR (∼20/32) or better, and 93.5% had a UDVA of 0.0 logMAR (∼20/20) or better. One inlay was removed after 36 months because of patient dissatisfaction with vision after a hyperopic shift in the surgical eye, with no loss of CDVA or CNVA 2 years after removal.


CONCLUSIONS
Long-term results of monocular corneal inlay implantation indicate increased UNVA and UIVA and slightly compromised UDVA in emmetropic presbyopic eyes.


BACKGROUND
Dr. Grabner was reimbursed for travel expenses from Acufocus. Dr. Riha is a consultant to Acufocus. No other author has a financial or proprietary interest in any material or method mentioned.
From the Department of Ophthalmology, Paracelsus Medical University in Salzburg, Salzburg, Austria. Electronic address: a.dexl@salk.at.
Alois K
AK
Dexl
From the Department of Ophthalmology, Paracelsus Medical University in Salzburg, Salzburg, Austria.
Gerlinde
G
Jell
From the Department of Ophthalmology, Paracelsus Medical University in Salzburg, Salzburg, Austria.
Clemens
C
Strohmaier
From the Department of Ophthalmology, Paracelsus Medical University in Salzburg, Salzburg, Austria.
Orang
O
Seyeddain
From the Department of Ophthalmology, Paracelsus Medical University in Salzburg, Salzburg, Austria.
Wolfgang
W
Riha
From the Department of Ophthalmology, Paracelsus Medical University in Salzburg, Salzburg, Austria.
Theresa
T
Rückl
From the Department of Ophthalmology, Paracelsus Medical University in Salzburg, Salzburg, Austria.
Alexander
A
Bachernegg
From the Department of Ophthalmology, Paracelsus Medical University in Salzburg, Salzburg, Austria.
Günther
G
Grabner
D001672:Biocompatible Materials; D003319:Corneal Stroma / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011145:Polyvinyls; D011183:Postoperative Complications; D011305:Presbyopia / Q000503:physiopathology / Q000534:rehabilitation / Q000601:surgery*; D011446:Prospective Studies; D019736:Prostheses and Implants; D019919:Prosthesis Implantation; D012029:Refraction, Ocular / Q000502:physiology; D016896:Treatment Outcome; D015348:Vision, Binocular / Q000502:physiology; D014792:Visual Acuity / Q000502:physiology; D005465:Fluorocarbon Polymers
D001672:Biocompatible Materials; D011145:Polyvinyls; C024865:polyvinylidene fluoride; D005465:Fluorocarbon Polymers