Epithelial remodelling induced by a corneal hydrogel shape changing inlay

Session Details

Session Title: Refractive
Session Date/Time: Friday 10/02/2017 | 10:30-12:30
Paper Time: 11:00
Venue: Brussels Room 0.4

First Author: B. Cochener FRANCE
Co Author(s): E. Barragan  A. Chayet              

Abstract Details

Purpose:

To demonstrate alterations to the anterior stroma and epithelial thickness profiles induced by biomechanical remodeling of the cornea, in the presence of the Raindropﾮ Near Vision Inlay.

Setting:

Centre Hospitalier Universitaire de Brest ﾖ CHU, Brest Cedex, France; ReVision Optics, Inc. Lake Forest, CA, USA; Laser Ocular Hidalgo, Monterrey, Mexico; Codet Vision, Tijuana, Mexico

Methods:

30 emmetropic presbyopes were implanted at two clinical research sites. From cross-sectional OCT images (Optovue, Inc., Fremont, CA, USA) at 6M, the anterior and posterior surface, the inlay boundaries, and Bowmanﾒs layer were digitized using custom MatLab (MathWorks, Inc., Natick, MA, USA) software. Biomechanical changes to the anterior stroma are reflected in Bowmanﾒs layer (?Bow), and epithelial changes in the epithelial thickness profile (?Epi). The change to the anterior corneal surface (?C) is related by ?C = ?Bow + ?Epi. ?C was calculated from postoperative minus preoperative wavefront measurements, more accurate than OCT (5 micron/pixel). ?Bow was calculated as above.

Results:

On average, 8% of the inlay volume is absorbed by the anterior stroma (average flap depth of 154 ﾱ 14 microns), with ?Bow maintaining substantially the inlay shape with a 26 micron central rise. This ﾓBowman volumeﾔ is redistributed by epithelial remodeling, resulting in ?C height increase of 9 microns on average, extending to about twice the inlay diameter. On average, ?Epi thins by 17 microns centrally, with no significant reports of SPK at or prior to the six month exam. Sub-analysis of best case profiles suggests slight peripheral epithelial thickening, just outside the inlay diameter.

Conclusions:

The Raindrop Inlay remodels the cornea to provide a progressive prolate shape. The anterior stroma absorbs 8% of the Raindrop Inlayﾒs volume. The epithelium redistributes the remaining volume, thinning by 17 microns with the final anterior corneal surface rising by 9 microns.

Financial Disclosure:

receives nonNonemonetary benefits from a company producing, developing or supplying the product or procedure presented.