Biomechanical-remodeling of the epithelium after implantation of a corneal hydrogel shape changing inlay

Session Details

Session Title: Presbyopia Management

Session Date/Time: Sunday 08/10/2017 | 16:30-18:00

Paper Time: 16:54

Venue: Room 2.1

First Author: : J.Guell SPAIN

Co Author(s): :    A. Lang   E. Barragan Garza   A. Chayet              

Abstract Details

Purpose:

Demonstrate biomechanical changes to the anterior stroma and epithelial thickness profiles induced by remodeling of the anterior cornea, in the presence of the Raindrop® Near Vision Inlay.

Setting:

Instituto de Microcirurgia Ocular, Unidad de Cornea y CirurgiaRefractiva, Barcelona, Spain;Laser Ocular Hidalgo, Monterrey, Mexico;Codet Vision, Tijuana, Mexico; ReVision Optics, Inc. Lake Forest, CA, USA.

Methods:

30 subjects were implanted with a corneal inlay in the non-dominant eye. From cross-sectional OCT images (Optovue, Inc., Fremont, CA, USA) at 6M, the anterior and posterior surface, the inlay boundaries, and Bowman’s layer were digitized using custom MatLab (MathWorks, Inc., Natick, MA, USA) software. Biomechanical changes to the anterior stroma are reflected in Bowman’s layer (ΔBow), and epithelial changes in the epithelial thickness profile (ΔEpi). The change to the anterior corneal surface (ΔC) is related by ΔC = ΔBow + ΔEpi. ΔC was calculated from postoperative minus preoperative wavefront measurements. ΔBow was calculated as above.

Results:

On average, 8% of the inlay volume is absorbed by the anterior stroma (flap depth of 154 ± 14 microns), with ΔBowmaintaining substantially the inlay shape with a 28-micron central rise. This “Bowman volume” is redistributed by epithelial remodeling, resulting inΔCheight increase of 10 microns on average, extending to about twice the inlay diameter. On average, ΔEpithins by 18 microns centrally, with no significant reports of SPK at or prior to the six-month exam. There was a slight peripheral epithelial thickening, just outside the inlay’s 2 mm diameter.

Conclusions:

Implantation of theRaindrop Inlay causes the anterior stroma to absorb 8% of the inlay’s volume. The epithelium redistributes the remaining volume, thinning by 18 microns with the final anterior corneal surface rising by 10 microns. The flap of the stroma takes on predominately the inlay’s shape to create a profocal add power zone.

Financial Disclosure:

research is funded, fully or partially, by a competing company