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Sequential retinal detachment and cataract surgery in a patient implanted with a small-aperture corneal inlay

Poster Details

First Author: N.Jabbur LEBANON

Co Author(s):    S. Awwad   Z. Bashshur           

Abstract Details



Purpose:

To report techniques and pearls as well as visual outcome in a patient who underwent successful LASIK and Kamra implantation and required, 21 months later, sequential retinal detachment and cataract surgery. All surgeries were done without explantation of the corneal inlay.

Setting:

University Hospital

Methods:

The KAMRA inlay (AcuFocus, Irvine, CA) is a 5 micron thick implant measuring 3.8mm in total diameter with a 1.6mm central aperture. Twenty-one months after successful small-aperture corneal inlay implantation with simultaneous myopic LASIK, a patient presented with decreased visual acuity to 20/200 due to a superior macula-involving retinal detachment (RD). Pars plana vitrectomy (PPV), trans-scleral cryotherapy around the retinal breaks, and 16% C3F8 gas tamponade were performed with the inlay in situ. Three months later, she underwent uneventful phacoemulsification of a visually significant cataract with posterior chamber intraocular lens implantation with the inlay in situ.

Results:

All procedures were performed without incident. The PPV was possible without explanting the inlay because of indirect wide-angle non-contact visualization system. It was possible to visualize the posterior pole up to the mid-periphery through the Kamra inlay and access to the periphery was possible by rotating the eye to visualize the fundus around the inlay. Similar maneuvers were employed during the cataract extraction whenever the inlay appeared in the way. Three months postop, the patient regained her pre-RD distance uncorrected distance visual acuity of 20/25+ and UCNVA of J1. The corneal inlay remained in its initial implantation location at all times. Video of the surgical procedure will be presented.

Conclusions:

PPV as well as cataract extraction with IOL implantation are possible with the inlay in situ. An indirect non-contact visualization system of the retina is especially helpful during PPV. Special considerations are to be taken for IOL calculation after simultaneous LASIK and Kamra. FINANCIAL INTEREST: NONE

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