Visual Outcomes Following Removal Of Corneal Inlay And Implantation Of A Small-Aperture Intraocular Lens During Cataract Surgery
Published 2025 - 43rd Congress of the ESCRS
Reference: PP22.10 | Type: Free paper | DOI: 10.82333/vxme-9111
Authors: Freja Bagatin* 1 , Renata Iveković 1 , Ivana Radman 1 , Karla Ranđelović 1 , Ivanka Petric Vicković 1 , Valentina Lacmanović Lončar 1 , Zoran Vatavuk 1
1Ophthalmology,Clinical Hospital Centre "Sestre milosrdnice",Zagreb,Croatia
Purpose
As patients who have been implanted with a Kamra small-aperture corneal inlay age and develop cataracts, they may prefer to maintain spectacle independence. Surgeons must choose whether to leave the inlay in place or remove it and replace it with a presbyopia-correcting IOL. This study evaluates the results of cataract surgery with implantation of a small-aperture IOL after removal of the corneal inlay.
Setting
Private clinical practice in Makati City, Philippines
Methods
In this prospective study, 13 patients with cataracts and otherwise healthy eyes who had previously had a Kamra inlay implanted in one eye were enrolled. The inlay was removed and the eye monitored for corneal and refractive stability prior to implantation of the Apthera IC-8 IOL. IOL power was calculated before and after inlay removal using the Barrett Universal II formula. Visual outcomes and subjective questionnaire data were collected at 1, 3, 6, and 12 months (M) following IOL implantation.
Results
Mean monocular uncorrected distance, intermediate, and near visual acuity were 0.10 logMAR (20/25), 0.05 logMAR (20/22), and 0.05 logMAR (20/22), respectively, 12M after Apthera IOL implantation. Mean MRSE was -0.64 at 12M. Mean residual astigmatism was 0.654 D. Monocular uncorrected near with the IOL was within 1 line of near vision with the inlay in place. There was no change in the calculated IOL powers before and after inlay removal. At screening, 8.3% of eyes had 1+ corneal haze, 75% had 2+ and 16.7% had 3+. At 12M, 15.4% of the Apthera eyes had 1+ corneal haze, 84.6% had 2+ and there was no case of 3+ haze. Spectacle independence increased for tasks at all distances and 92% of patients would choose the same procedure again.
Conclusions
Kamra inlays can be easily removed prior to cataract surgery. The Apthera IOL provides an extended range of vision from distance to near with increased spectacle independence and good patient satisfaction in patients with prior Kamra inlay.