Long-Term Outcomes and Biocompatibility of Small-Aperture Corneal Inlay

Sunday, April 19, 2015: 3:41 PM
Room 1A (San Diego Convention Center)
Wolfgang Riha, MD
GŁnther Grabner, MD

Purpose
To evaluate the long-term visual outcomes and biocompatibility of a small aperture inlay implanted monocularly for the treatment of presbyopia.

Methods
A total of 32 emmetropic presbyopes between 45 and 55 years of age, underwent monocular implantation of a 3.8mm small aperture inlay (central aperture: 1.6mm) between 2006 and 2007. The inlay was implanted under a femtosecond-LASIK flap approximately 170 μm thick and centered on the first Purkinje-reflex. Monocular and binocular uncorrected and corrected visual acuities for distance (UDVA, CDVA), intermediate (UIVA), and near (UNVA, CNVA), manifest refraction, patient satisfaction and complications were evaluated pre- and post-operatively (1 week and 1, 3, 6, 9, 12, 18, 24, 30, 36, 48, and 60 months.

Results
At 1 months, mean UNVA improved from J7/J8 (preop) to J2, mean UIVA improved from 20/40 to 20/25 and mean UDVA decreased from 20/16 to 20/25. Results for the inlay implanted eye remained constant over the 60 month follow-up.  To date, only two inlays in this series have been removed. Reason for removal was dissatisfaction with vision subsequent to a refractive change in the implanted eye. Two inlays were recentered. Patient satisfaction was high with only 3 patients reporting they wouldn’t choose the procedure again.

Conclusion
Monocular implantation of a small-aperture corneal inlay improved uncorrected near vision by 4 lines and uncorrected intermediate vision by 1 line with only a slight compromise in uncorrected distance vision. Post-inlay implantation visual acuity stabilizes by one month and is maintained over the long-term.