Three-Year Postoperative Objective and Subjective Results of Small-Aperture Corneal Inlay for Correction of Presbyopia
Narrative Responses:
Purpose
To report the 3-year postoperative objective and subjective results in addition to the quality of vision assessment with a small aperture corneal inlay for correcting presbyopia.
Methods
This prospective, non-randomized study included 70 presbyopic, emmetropic or ametropic patients. The intracorneal inlay was implanted in the non-dominant eye (IE) and was centered between the first purkinje reflex and the center of the pupil. A 200 microns depth superior-hinged flap or an intrastromal pocket was created with the IntraLase 60-kHz femtosecond laser. The monocular and binocular UCDVA, UCNVA, defocus curve and refractive stability were measured. In addition, subjective satisfaction was assessed with a questionnaire and objective quality of vision and tear film analysis were measured with a double pass system.
Results
At 3 years, mean uncorrected distance visual acuity was 0.10 +/- 0.05 LogMAR in the IE. The mean uncorrected near visual acuity improved significantly from 0.5 +/- 0.1 pre-operatively to 0.2 +/- 0.05 LogMar at 3 months post operatively and remained stable up to 3 years. Two inlays were explanted: one at 18 months because of hyperopic shift associated with corneal haze, and one at 1 month post-op for an unsatisfied patient. Objective tear film analysis revealed more important dry eye in the IE in comparison to the contralateral eye. Ninety percent of the patients would do the surgery again.
Conclusion
Small aperture corneal inlay seems to provide a safe and effective treatment for presbyopia over follow-up of 3 years. Selection of good candidates is essential in order to obtain satisfactory results.