Wound-healing response of different pocket configuration on presbyopic inlay

Session Details

Session Title: Corneal Inlays for Presbyopia Correction

Session Date/Time: Sunday 11/09/2016 | 16:30-18:00

Paper Time: 16:42

Venue: Hall C1

First Author: : J.Mehta SINGAPORE

Co Author(s): :    A. Konstantopoulos   Y. Liu                 

Abstract Details

Purpose:

Corneal inlays are a relatively new option for the surgical compensation of presbyopia. The primary aim of this study was to investigate the effect of corneal pocket dimension and configuration on corneal stability and inflammatory response after Raindrop inlay implantation.

Setting:

Singapore Eye Research Institute

Methods:

Using a rabbit model of corneal wound healing, 10 NZ rabbits underwent pocket creation using 1 of 4 different normograms (5 eyes in each group). Following creation of different pockets using a femtosecond laser the rabbits underwent implantation with the Raindrop™ presbyopic inlay. The rabbits were examined under anesthesia before surgery, at day 1, and weeks 1, 2, 3 and 4 following surgery. They were euthanized after week 4 examinations. Examination included slit lamp biomicroscopy, ASOCT, Atlas corneal surface topography and in vivo confocal microscopy (IVCM). Following euthanasia the corneas underwent immunofluorescence for CD11b, HSP 47 and fibronectin and TEM.

Results:

All pockets remained clear. ASOCT showed increase in central CT on day 1, weeks 1-4 (p=0.03). There was no sig diff between week 1 and later time points and no sig diff between different normograms. Refractive power increased at day 1 and weeks 1 - 4. There was a sig difference (p<0.05) between day 1 and other time points, but no difference after. IVCM inlay plane was acellular. Highly reflective keratocytes were seen adjacent to the inlays. The 4mm pocket group had the highest stromal keratocyte reflectivity (p=0.033, p<0.005, and p<0.005). Tissue sections showed no expression of CD11b, fibronectin or HSP47. TEM showed a regular arrangement of collagen around the inlay.

Conclusions:

Refractive power and ASOCT increased postop and remained stable by 1 week. The inlay was well tolerated with minimal inflammatory response on immunohistochemistry and TEM. There was greater response on IVCM on the 4mm pocket compared to 6-8mm.

Financial Disclosure:

NONE