Causes for explantation of small aperture corneal inlays
Session Details
Session Title: Corneal Inlays for Presbyopia Correction
Session Date/Time: Sunday 11/09/2016 | 16:30-18:00
Paper Time: 16:48
Venue: Hall C1
First Author: : J.Machat CANADA
Co Author(s): :
Abstract Details
Purpose:
Review indications for and incidence of removal of small aperture corneal inlays
Setting:
Private clinical practice, Toronto, Canada
Methods:
Retrospective analysis of the incidence of and reasons for explantation in one surgeon’s first 300 small-aperture corneal inlay cases. The first 13 KAMRA corneal inlays were implanted beneath a 200-micron femtosecond created flap, the remaining cases within a 200- to 280-micron femtosecond-created pocket. Inlay depth and implantation style (flap vs. pocket) are reported, as well as management of complications prior to removal.
Results:
Eight of 300 inlays (2.7%) were removed. Half the removals (4) occurred in the first 100 eyes treated, 3 in the next hundred, and 1 in the third set of 100 eyes. Two of the first four removals occurred in the first 13 cases where the inlay was placed beneath a thick flap. Inlay removal was indicated for night glare (1 eye); wound healing effects (3 eyes); dissatisfaction with near vision (3 eyes), and lens aberrations reducing vision (1 eye). The femtosecond laser pocket technique, aggressive ocular surface management, and tight patient selection criteria were associated with fewer complications.
Conclusions:
Removability is an advantage of corneal inlays over other types of refractive surgery. Although there is a learning curve for inlay implantation, the overall rate of explantation in this series was less than 3%, and in cases of pocket implantation roughly 2%. With experience, proper patient selection and postoperative management, surgeons can minimize the need for removal.
Financial Disclosure:
... receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented
