First Author: S.Kandelman BRAZIL
Co Author(s):
Purpose:
To show the clinical results of Presbia Flexivue Microlens™ implanted in a variety of out of the normal indication of use scenarios, seeking a possible widening of the range of indications.
All patients were highly motivated in order to abolish, or at least substantially diminish, their visual dependency on glasses for near vision. They understood and consented, although having healthy eyes, that each had a slightly out of the normal clinical condition and may not achieve their desired outcome
Setting:
: Five patients were recruited (Skopus Ophthalmology Clinic and Femto-Rio Laser, both in Rio deJaneiro, Brazil) for the implantation of corneal inlays (Presbia®) in a pocket, using a femtosecond laser. Patients were also aware that the procedure is fully reversible allowing the explanation of the microlens at any time, if needed.
Methods:
Two of the patients had a previous small refraction defect for distance, which was for both a billateral hyperopic astigmatism (one patient (1) +1,00 sph<>-0,50 cyl @90 AO and the second patient (2) +0,75 sph<>-0,75 cyl @90 AO).
The next patient (3) had a high angle phoria with dominance alternation. The forth patient (4) had previous successful lasik surgery (about 10 years before) for -3,00 sph. AO. The last patient (5) in this series, being 50 years old was psedophakic in one eye, implanted with a monofocal IOL, refracting plano for distance and a healthy contralateral eye, and was presbyopic.
Results:
After Presbia Flexivue Microlens™ implantation, patients 1 and 2 had partial near vision improvement, maintained their distance refraction in the implanted eye and a wish to get even better. For this purpose they were submitted to a bilateral custom-PRK after 6 months of the initial surgery and after another month they were both showed improvement in visual acuity for distance and near, were spectacles independent and reported to be happy.
Patient 3 reported improvement in vision for near, although together with astenopic symptoms, being due to orthoptics physiotherapy so far.
Patient 4 also reported great improvement for near, although also reporting worsening for distance in this eye, refracting as -3,00 sph. At completion of a year out of surgery, considerations are being made to perform a Custom-PRK in order to avoid explanation and loss of near visual abilities as per patient desire.
Patient 5 reported improvement for near, without any additional remarks.
Conclusions:
Besides being presently a widely accepted technique with proven efficacy over thousands of implants in the recent years, with full peer-reviewed literature, Presbia Flexivue Microlens™ might have an even wider potential indications for use that indicated in its label. It might suit to treat patients in different clinical ophthalmological scenarios rather than only in emmetropic presbyopic eyes.
Additionally, it might keep its efficacy even in different combinations with other refractive techniques, as suggested by this small series of cases (Pre-PRK, Post-PRK, Post-Lasik and Post-phacoemulsification). Of course a larger number of patients should be studied, although the reversibility of the implants offers a crucial advantage.
Financial Disclosure:
None
