Bilateral Implantation of Hydrogel Corneal Inlays in Hyperopic Presbyopia Patients
Narrative Responses:
Purpose
To evaluate the feasibility of implanting bilateral Raindrop Near Vision Inlays (ReVision Optics, Inc., Lake Forest, CA, USA) in low hyperopic presbyopes.
Methods
All inlays were implanted using the dry technique under a femtosecond flap (1/3 CCT) onto the stromal bed, centered on the light constricted pupil. Twenty-three hyperopic (+1.00 to +1.75 D Sph, -0.75 D of cyl or less), presbyopic subjects were implanted with Raindrop in the non-dominant eye, followed for 3 to 6 months, and then implanted with a second inlay in the dominant eye. ETDRS Visual acuity, task performance, visual symptoms and patient satisfaction were evaluated. The non-dominant and dominant eyes in the same subject responded similarly to the corneal inlay and therefore results are presented for binocular vision.
Results
Uncorrected visual acuity for near (UNVA) improved from (mean) preop 0.54 logMAR to -0.04 logMAR at 3 months, and remained stable over time (p>0.05). Intermediate and Distance VA followed similar patterns (3 month visit, 0.02 logMAR UIVA, and 0.01 logMAR UDVA), all stable over the follow-up period. Photopic and mesopic task performance improved postoperatively at all distances. Mild halos were see at 3 months in 10% of patients, but disappeared at later visits. At 9 months, all patients implanted bilaterally with the Raindrop inlay were satisfied with the procedure.
Conclusion
In the young hyperopic presbyopes, bilateral implantation of the Raindrop Near Vision Inlay appears as an effective alternative to correct presbyopia. It improves near and intermediate vision without compromising distance VA; Task performance improves significantly at all distances, both for good light and more importantly, under dim lighting conditions.