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Meeting Reporter Results of corneal inlays for presbyopia By Enette Ngoei EyeWorld Contributing Writer SYMPOSIUM & CONGRESS 2014 APRIL 25–29 BOSTON Additional Programming Cornea Day ASCRS Glaucoma Day ASOA Workshops Technicians & Nurses Program Book Early for the Best Rates Housing is Now Open www.ascrs.org/gethousing A ttendees heard about the latest data in presbyopia treatment with corneal inlays at a scientific paper session on keratorefractive procedures. Stephen Slade, MD, Houston, discussed the one-year safety and efficacy results of a hydrogel corneal inlay by ReVision Optics (Lake Forest, Calif.) from a multicenter FDA prospective, nonrandomized clinical study. The inlays were implanted in the non-dominant eye, in emmetropes (–0.50 to +1.00 D). Dr. Slade presented results of the first 75 patients (75 eyes) that reached a sixmonth visit in phase 3a of the study. Visual acuity Monocular and binocular testing was conducted with near vision at 40 cm, intermediate vision at 80 cm, and distance vision at 4 m. Standardized ETDRS charts and consistent luminance were used. Patients were also given a survey to test satisfaction levels. Dr. Slade said implantation of the inlay, which changes the anterior curvature of the cornea, brought about an average gain of 5.5 lines at near in the non-dominant eye with 1 line of loss at distance in the nondominant eye. In the patient satisfaction survey, 5% declared mild to moderate halos and 3% declared moderate glare, he said, which are very gratifying results for the patients. The inlay has excellent centration, Dr. Slade said, and is safe as it's removable. Looking at the other options available, he said multifocal soft contact lenses do not center but are easily removable. Presbyopic IOL centration is not completely controllable and removal is potentially problematic, while presbyopic corneal ablations are readily centered, but "removal" is problematic, he said. Gunther Grabner, MD, Salzburg, Austria, presented the visual acuity and satisfaction results after five years with the KAMRA (AcuFocus, Irvine, Calif.) intracorneal inlay for presbyopia correction. As part of a prospective nonrandomized multicenter FDA study (U.S. and European sites), Dr. Grabner's paper included natural emmetropes between 45 and 55 years. The strict inclusion criteria such as no astigmatism and a spherical equivalent of +/–0.5 D meant that of 300 candidates screened, only 32 optimized cases were used in the study. The surgical procedure was performed in the non-dominant eye only with topical anesthesia. A flap was created at 170-200 microns depth µm, the KAMRA inlay was inserted, centered, and the flap was closed. The procedure takes less than 20 minutes from start to finish, Dr. Gunther said. The results showed the procedure to be an effective and safe treatment for presbyopia for up to six years, he said. There was improvement in NVA without significant loss of DVA. Dr. Gunther said the advantages of the procedure are that it is extraocular, removable, and minimally invasive. There are a variety of indications for the procedure, it is stable and well tolerated, and recentration possible, he said. The results also showed high patient satisfaction. EW Editors' note: Dr. Grabner has financial interests with AcuFocus. Dr. Slade has financial interests with ReVision Optics. Did you know ... Ninety-five percent of smartphone users have searched for local information with their smartphone Source: Xcube Labs