Photorefractive Keratectomy Over Opaque Intracorneal Inlay

Sunday, April 27, 2014: 2:12 PM
Room 154 (Boston Convention and Exhibition Center)
Kevin L. Waltz, OD, MD, Eye Surgeons of Indiana, Indianapolis, IN, USA
Nathan S. Smith, MD, Eye Surgeons of Indiana, Indianapolis, IN, USA
Brenda Wahl, OD, Eye Surgeons of Indiana, Indianapolis, Indiana, USA

Narrative Responses:

Purpose
To present a case-series of five eyes in five patients who received photorefractive keratotomy (PRK) over an opaque corneal inlay.

Methods
All eyes received a small aperture corneal inlay in their non-dominant eye for presbyopia correction as part of an FDA trial. All eyes developed consecutive a hyperopic shift after implantation of the device, but were otherwise clinically stable without evidence of corneal haze or other ocular pathology at the time of PRK intervention (3.3-4.2 years after inlay implantation). Each patient desired better uncorrected near vision in their eye containing the inlay. PRK treatments were preformed over the corneal inlay with a hyperopic treatment magnitude ranging from 1.5D to 3.625D. Uncorrected acuity, corrected acuity, and absence of complications were primary endpoints

Results
No significant complications occurred during or subsequent to PRK treatment. At 3-6 months follow-up,  UCDVA was 20/46 (range 20/25 to 20/100), UCNVA was 20/19.6 (range 20/16 to 20/30).  All eyes maintained BCDVA of 20/20.

Conclusion
PRK appears to be effective to treat symptomatic hyperopic shifts without disrupting the corneal pocket or inlay. This adjunctive treatment option should be considered as an option to bring more inlay patients to their desired UCNVA and depth of focus goals.