Evolution of corneal inlays for presbyopia correction

Session Details

Session Title: Multifocal IOLs and Advanced Optic

Session Date/Time: Tuesday 08/09/2015 | 09:00-10:30

Paper Time: 10:15

Venue: Main Auditorium

First Author: : P.Versace AUSTRALIA

Co Author(s): :                        

Abstract Details

Purpose:

To demonstrate the performance and safety of different corneal inlays used for presbyopia correction in a refractive surgery centre.

Setting:

Vision Eye Institute, Sydney Australia; a private practice refractive and cataract centre.

Methods:

60 consecutive cases of corneal inlay surgery spanning 6 years are reported. Three different inlays are used; Kamra (Acufocus, Irvine, CA USA), Presbia Flexivue (Presbia, Irvine, CA USA), and Raindrop (Revision Optics, Inc, Lake Forest, CA USA). Results with each and the reasons for abandoning one inlay for another are described. All patients were treated only for presbyopia and no concurrent refractive correction was performed.

Results:

Kamra was used as part of the U.S. FDA trial. >30% experienced ≥1.0D hyperopic shift after surgery. 10 (of 47) Kamra inlays were explanted. Flexivue was stable but patients lost CDVA in the operated eye; it did not return by 1yr PO. 3 (of 8) Flexivue inlays were explanted. Patient satisfaction was poor. Raindrop was best suited for emmetropes or low hyperopes with 100% seeing 6/6 and N5 binocularly at 1 month. NVA was N6 or better monocularly in 100% of operated eyes. Overall satisfaction was high and only 1 patient had mild haze requiring treatment.

Conclusions:

It is difficult for surgeons to know the real safety and outcomes with presbyopia correcting corneal inlays as the presented data often does not match results achieved in the real clinical situation. Here we concentrate on safety and success with different corneal inlays and demonstrate the need to remain vigilant to outcomes and be prepared to abandon a product that is not safe. Raindrop is now our preferred treatment for the emmetropic presbyope as it has minimal impact on UDVA, high patient satisfaction, and excellent results for spectacle independence.

Financial Interest:

One of the authors travel has been funded, fully or partially, by a company producing, developing or supplying the product or procedure presented