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Five year outcomes on patients implanted with a small-aperture corneal inlay

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Session Details

Session Title: Presbyopic Corrections

Session Date/Time: Monday 15/09/2014 | 16:30-18:30

Paper Time: 16:42

Venue: Boulevard F (Level 1)

First Author: : G.Grabner AUSTRIA

Co Author(s): :    W. Riha   A. Dexl   T. Ruckl   G. Jell   O. Seyeddain   C. Strohamaier

Abstract Details


To evaluate the long-term outcomes post-implantation of the KAMRA (AcuFocus, Irvine, CA) small-aperture intra corneal inlay (Model ACI7000) for the surgical correction of presbyopia.


Paracelsus Medical University Salzburg, Austria – Department of Ophthalmology


This is a single-center, single-surgeon, prospective, interventional cohort study. A total of 32 emmetropic presbyopes between 45 and 55 years of age, underwent monocular implantation of a 3.8mm small aperture inlay (central aperture: 1.6mm) between 2006 and 2007. The inlay was implanted under a femtosecond-LASIK flap and centered on the first Purkinje-reflex. Monocular and binocular uncorrected and corrected visual acuities for distance (UDVA, CDVA), intermediate (UIVA), and near (UNVA, CNVA), refraction, patient satisfaction and complications were evaluated pre- and post-operatively (1 week and 1, 3, 6, 9, 12, 18, 24, 30, 36, 48 and 60 months).


At 60 months, the mean binocular uncorrected visual acuities improved from J6 ± 1.2 lines (~20/50) to J2 ± 1.8 lines (~20/25; UNVA, P<.001), 0.2 logMAR ± 1.3 lines (~20/32) to 0.1 logMAR ± 1.3 lines (~20/25; UIVA, P=0.04) with a slight decrease in UDVA (-0.2 logMAR ± 0.2 lines (~20/12.5) to -0.1 logMAR ± 0.6 lines (~20/16); P<.001). At 5 years, 74.2% of patients had UNVA of ≤J3 (~20/32), 87.1% UIVA of ≤0.2 logMAR (~20/32) and 93.5% UDVA of ≤0.0 logMAR (~20/20). Two inlays needed to be repositioned at 6 months. Both patients experienced significant improvements in acuity after repositioning. One inlay was removed after 36 months due to dissatisfaction with vision subsequent to an early wound healing response in the implanted eye, with no loss of CDVA and CNVA 2 years post – removal.


Monocular implantation of the small-aperture corneal inlay improved uncorrected near vision by 4 lines and uncorrected intermediate vision by 1 line with only a slight compromise in uncorrected distance vision. Post-inlay implantation visual acuity stabilizes by one month and is maintained over the long-term.

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