Improving Visual Acuity in Accommodating IOL Patients With Corneal Inlay
Narrative Responses:
Purpose
To evaluate the effectiveness of corneal inlay implantation to improve near vision in patients previously implanted with an accommodating IOL.
Methods
Prospective single center clinical trial. Three accommodating IOL patients (Crystalens, Bausch & Lomb) with a preoperative spherical equivalent of +0.50D to -0.75D and uncorrected near visual acuity of 20/40 to 20/100 have been implanted monocularly with a small aperture corneal inlay (KAMRA Inlay, AcuFocus, Inc.). Inlays were implanted after flap creation using a femtosecond laser in the non-dominant eye. Uncorrected and distance-corrected near, intermediate and distance acuities were measured pre-inlay and 3 months post-inlay implantation. Subject satisfaction and visual symptoms were measured using a subjective questionnaire.
Results
Mean UCNVA in the inlay-implanted eye improved from 20/50 pre-inlay to 20/25 post-inlay (p = 0.039). Mean UCIVA remained unchanged at 20/25. Mean monocular UCDVA decreased by a line from 20/20 to 20/25. Mean BCDVA and DCIVA remained unchanged at 20/20 and 20/25 respectively. Mean DCNVA improved by a line from 20/40 to 20/30. Satisfaction scores were measured on a scale of 1 to 7, with 7 being very satisfied. Pre-inlay, patients rated their ability to read a newspaper/menu and see a computer screen with a mean score of 3.6. Post-inlay, the scores were 6 and 6.7 respectively.
Conclusion
In this case series, eyes implanted with the small aperture inlay showed a significant 3 line improvement in near vision in eyes previously implanted with an accommodating IOL without significant compromise to intermediate and distance vision.