PRESBYOPIC INLAY

Preliminary results with corneal inlay yields promising outcomes in presbyopic emmetropes

The initial European experience with the Vue+ corneal inlay (Revision optics) demonstrates very good visual results at near and intermediate, with no significant loss of distance vision, according to Antonio Limao oliveira MD.

[caption id='attachment_213' align='alignnone' width='500' caption='Two animated eyes representing the inlay. Courtesy of Antonio Limao Oliveira MD']

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Dr Limao oliveira reported the results achieved in 15 plano presbyopic patients implanted with the inlay as part of a multicentre European trial. The patients included nine women and six men ranging in age from 45 to 60 years. Their preoperative manifest spherical equivalent had a mean value of +0.43 D and was between -0.50 D and +1.00 D in all eyes. Their preoperative near addition had a mean value of 1.93 D and was between 1.00 D and 2.50 D in all eyes, and no eyes had more than 0.75 D of cylinder.

In addition, all patients had experienced satisfactory results with contact lens-based monovision, and all had healthy corneas, free of dry eye, and all had clear crystalline lenses. All underwent implantation of the Vue+ hydrogel corneal inlay beneath a flap 150 microns thick and 8.5mm in diameter created with a femtosecond laser. The inlay is thinner than a human hair, has a diameter of 2.0mm and has a refractive index and water content similar to the cornea. â€œThe Vue+ corneal inlay, with concurrent LASIK, may also restore near and intermediate vision in patients with myopic and hyperopic presbyopia. It enhances near vision by producing a region of increased curvature in the centre of the pupil,â€ Dr Limao oliveira said.

At six monthsâ€™ follow-up, uncorrected near acuity improved from a mean of 20/65 to 20/20, with a mean gain of five lines. The mean uncorrected distance visual acuity fell slightly from a preoperative value of 20/20 to 20/30. Most of the change in near visual acuity occurred by the first postoperative day, he noted.

â€œWe observed a real wow effect in terms of near vision which improved to 20/32 at day one. In contrast, distance vision was considerably reduced at day one from 20/20 to 20/55 but continued to improve towards normal values afterwards,â€ Dr Limao oliveira said.

In addition, the mean uncorrected intermediate visual acuity was 20/25 or better both in the operated eye alone and binocularly. Furthermore, no eyes lost any lines of best-corrected vision.

Moreover, all patients expressed satisfaction with their vision at all distances and rated their satisfaction level at a mean of 3.8 on a scale from one to five. Patients reported a minimal amount of visual symptoms such as glare and haloes, he said. The study will continue for plano presbyopia and concurrent LASIK at centres in Portugal, Spain, Belgium, the UK, Germany and France. A US FDA trial is also under way.