Bilateral Implantation Of A Supplementary Intraocular Pinhole For Irregular Corneal Astigmatism

To evaluate safety and efficacy of bilateral implantation of a supplementary intraocular pinhole to treat irregular corneal astigmatism.

Patients with bilateral irregular corneal astigmatism consented for implantation of a supplementary intraocular pinhole were enrolled. Mean follow-up was 27 months (range 5 to 66 months). Patients were assessed in their scheduled follow-up visits and monocular and binocular uncorrected and corrected distance and near visual acuity were recorded. Assessment of darkening vision complaints was also performed after implantation in the first eye and repeated after second-eye surgery.

19 patients were enrolled. Three patients were excluded because of darkening vision complaints after surgery in the first eye. This way, 32 eyes of 16 patients were analysed. Mean monocular and binocular uncorrected distance visual acuities improved from logarithm of the minimum angle of resolution 1.091 ± 0.208 and 1.078 ± 0.259 preoperatively to 0.342 ± 0.091 (p<0.001) and 0.342 ± 0.147 (p=0.001) 1 year postoperatively. No major complications were noted after implantation of the intraocular pinhole.

Bilateral implantation of a supplementary intraocular pinhole is a safe technique in a selected group of patients. There was an improvement in visual acuity sustained over the analysed period. Postoperative darkening vision complaints vary between individuals and can limit the application of this approach in certain patients.