Staging Refractive Correction and Inlay Implantation for Treatment of Ametropic Presbyopia

Monday, April 28, 2014: 1:51 PM
Room 154 (Boston Convention and Exhibition Center)
Jeffery J. Machat, MD, FRCSC, Crystal Clear Vision, Toronto, Ontario, Canada

Narrative Responses:

Purpose
To determine the optimal timing between LASIK and inlay implantation procedures to maximize visual outcomes in ametropic presbyopic patients.

Methods
A series of ametropic presbyopes were treated with a 2-stage dual-interface surgical procedure.   A traditional LASIK procedure targeting for -0.75 D residual refraction and lamellar pocket are performed/created in stage 1.  In stage 2, a corneal inlay is implanted. Patients with low to moderate refractive errors (-4.00 D to +2.00 D) were implanted 3 days post-LASIK. Patients with higher refractive errors (<-4.00 D and>+2.00 D) were implanted a minimum of 1-month post-LASIK to ensure target refraction was achieved. Uncorrected near and distance visual acuities and mean spherical equivalent refraction are reported at pre-op, 1-week, 1-month, and 6-months.

Results
Mean UCNVA improved by 2-3 lines from 20/43 preoperatively to 20/29, 20/26, 20/23 at 1-week (n=48), 1-month(n=27) and 6-months (n=7) post-operatively.  Mean UCDVA improved by 1-2 line from 20/30 preoperatively to 20/26, 20/26 and 20/21 at 1 week, 1 month and 6 months postoperatively. Mean MRSE changed from -0.47 ± 1.52D preoperatively to -0.71 ± 0.56D, -0.61 ± 0.38D and -0.73 ± 0.37D post-operatively.

Conclusion
Early results show simultaneous improvements in uncorrected near and distance visual acuity and the target refractive endpoint was achieved.  Additional comparative results to be presented.