Inlay shows good results for presbyopia in postLASIK eyes

Chicago-Results from a small study indicate the feasibility, safety, and efficacy of improving near vision in patients with previous LASIK by implanting a small-aperture corneal inlay (KAMRA, AcuFocus) into a femtosecond laser-created corneal pocket, said Francisco Sanchez Leon, MD.

The study included seven patients who had prior LASIK for distance correction 7 months to 7 years earlier, said Dr. Sanchez Leon, Novavision Laser Center, Naucalpan, Mexico.

Eligibility criteria for the procedure required patients to be between 45 and 60 years of age with 20/20 or better uncorrected distance visual acuity in the untreated eye, uncorrected near visual acuity of J4 or worse in the treatment eye, SE between 0 and –0.75 D, and cylinder ≤0.75 D. The LASIK flap had to be ≤160 μm as measured by OCT and total corneal thickness had to be >480 μm.

The pocket for the inlay was created using a femtosecond laser (Femto LDV Crystal Line, Ziemer); it measured 6.5 mm wide and was made to be at least 100 μm below the LASIK flap and to leave at least 250 μm of residual posterior stroma. Centration of the inlay was achieved using the AcuTarget device.

The data collected showed that the corneal pocket for implantation of the small-aperture corneal inlay could be created safely beneath a previous LASIK flap and that the inlay could be safely and precisely inserted to correct presbyopia. At 12 months, near uncorrected visual acuity (UCVA) had improved from J5 or worse preoperatively to J2 or better, distance UCVA was 20/25 or better in all eyes, and there was no evidence of injury to the cornea or flap structure by clinical assessment or Fourier domain optical coherence tomography.

“Our experience shows there were no safety issues with this procedure and that it resulted in significant improvement in near visual acuity with minimal impact on distance vision,” Dr. Sanchez Leon said. “Therefore, we believe it is a promising technique to treat presbyopia in appropriately selected patients with prior LASIK.”

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