Initial Experience With Corneal Inlays With Femto Pocket Implantation to Correct Presbyopia
Narrative Responses:
Purpose
Presbyopic inlays are now in the market since long (off-label use for USA). Kamra inlays being the oldest in the market were picked up by us. Availability of a pocket software with the Ziemer Femtosecond laser makes it more attractive to implant the Kamra inlay, precisely and with minimal complications.
Methods
Ten plano prebyopic patients (6 Females and 4 Males) within the age group of 45-59 years(mean 49 years) were slected for a uniocular implantation of the Kamra inlay using pocket softwear from Ziemer femtosecond laser. Preoperative assesment was similar to LASIK but in addition we also performed the accutarget, automated perimetry, specular microscopy and OCT. Kamra inlay was implanted in the nondominant eye of the patient under topical anesthesia after making a pocket of at a depth of 220u. Positioning of the inlay was done on the first Purkinjee image. Patients with angle kappa of more than 300 microns were excluded.
Results
All patients 100%(10 patients) were followed-up on 1st 7th, 15th, 30th, 60th, and 90th day. At the first week follow-up 70%(7 patients) were 20/20 and j1 30%(3 patients) were 20/20 and J2. Patients were comfortable from day 1 and were adjusted to the inlay by one week. Accutarget was performed at 1 and 2 months to determine the position of the inlay. Inlay was in desired position in 100%(10 patients). None of the patients complained of a significant glare or haloes. We also comfortably could perform all inestigative procedures. One patient developed a small myopic shift on topography.
Conclusion
Kamra inlay, implanted with a pocket software with Ziemer femtosecond laser at a depth of 220 microns is very safe. 3-month follow-up showed a full satisfaction. Ocular surface problems associated with flap creation were not encountered. The distance vision was not sacrificed. 100% patients said they would recommend this procedure.