J Korean Ophthalmol Soc.  2015 Dec;56(12):1840-1847. 10.3341/jkos.2015.56.12.1840.

Comparison of Intracorneal Inlay for Presbyopia Correction: Hydrogel and Small-Aperture Inlays with a Six- Months Follow-Up

• Lee JY
• Yoo AR
• Lee JY
• Lim DH
• Kim JY
• Kim MJ
• Chung TY
• Chung ES
• Tchah HW

• KMID: 2148743
• DOI: http://doi.org/10.3341/jkos.2015.56.12.1840

Abstract

PURPOSE
To study the safety and efficacy of corneal reshaping and small-aperture inlays and compare the clinical results.
METHODS
From February 2014 to November 2014, 22 corneal reshaping inlays were inserted at Asan Medical Center and from October 2012 to March 2013, 26 small-aperture inlay surgeries were performed: 6 eyes at Asan Medical Center and 20 eyes at Samsung Medical Center. The preoperative and postoperative parameters were reviewed retrospectively and included monocular uncorrected distance visual acuity (UDVA; log MAR), uncorrected near visual acuity (UNVA; log MAR), refraction and corneal curvature based on automated refractor keratometry, reading distance and patient satisfaction.
RESULTS
In the hydrogel inlay group, preoperative mean monocular UNVA was 0.83 +/- 0.05 and monocular UDVA 0.07 +/- 0.03. At 6 months, mean monocular UNVA was 0.23 +/- 0.05 and UDVA 0.05 +/- 0.02. The most preferred mean reading distance in the hydrogel inlay group was 39.38 +/- 3.18 cm. In the small-aperture inlay group, preoperative mean monocular UNVA was 0.4 +/- 0.06 and monocular uncorrected visual acuity 0.27 +/- 0.04. At 6 months, mean monocular UNVA was 0.11 +/- 0.02 and UDVA 0.09 +/- 0.05 and the most preferred mean reading distance was 44.23 +/- 5.17 cm. Although 85% of patients in the corneal reshaping inlay group were satisfied or very satisfied, only 20% of patients in the small-aperture inlay group were satisfied.
CONCLUSIONS
Both inlays are considered good options for correcting presbyopia. However, postoperative satisfaction score was higher and less glare symptoms were reported in the hydrogel inlay group.

Keyword

Corneal inlay; Corneal reshaping inlay; Presbyopia; Small-aperture inlay

MeSH Terms

Chungcheongnam-do
Follow-Up Studies*
Glare
Humans
Hydrogel*
Inlays*
Patient Satisfaction
Presbyopia*
Retrospective Studies
Visual Acuity
Hydrogel

Figure

• 

  Figure 1. Perioperative changes in mean and standard devia-tion of monocular UNVA (log MAR) in surgical eyes over 6 months of follow-up. Preop = preoperative; Postop = post-perative; UNVA = uncorrected near visual acuity. * p < 0.05, the comparison with just before the time point.

• 

  Figure 2. Perioperative changes in mean and standard devia-tion of monocular UDVA (log MAR) of surgical eyes over 6 months of follow-up. Preop = preoperative; Postop = post-perative; UDVA = uncorrected distance visual acuity. * p < 0.05, the comparison with just before time point.

• 

  Figure 3. Perioperative changes in mean and standard devia-tion of spherical equivalent (diopters) of surgical eyes over 6 months of follow-up. Preop = preoperative; Postop = post-perative; MRSE = manifest refraction spherical equivalent. * KAMRA data obtained from only Asan Medical Center (total 6 patients).

• 

  Figure 4. Perioperative changes in mean and standard devia-tion of keratometric values (diopters) of surgical eyes over 6 months of follow-up. Preop = preoperative; Postop = post-perative; K = keratometric reading. * KAMRA data obtained from only Asan Medical Center (total 6 patients).

• 

  Figure 5. Perioperative changes in mean and standard devia-tion of preference reading distance (cm) of surgical eyes over 6 months of follow-up. Postop = postoperative. * p < 0.05, the comparison with just before time point; † KAMRA data ob-tained from only Asan Medical Center (total 6 patients).

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