Abstract
BackgroundTo evaluate the 6-month clinical outcomes of Flexivue Microlens refractive corneal inlay in emmetropic patients in Asia for the surgical compensation of presbyopia.MethodsIn this retrospective study, corneal inlay implantation was done using a femtosecond laser. The follow-up period was 6 months. Near/intermediate/distant visual acuities, refraction, keratometry, defocus curve, wavefront aberrations, contrast sensitivity, Scheimpflug corneal scanning, endothelial cell density, dry eye test, confocal microscopy scanning, and patient questionnaires were evaluated.ResultsThe inlay implantation was performed in 21 eyes from June 2015 to April 2017. 6 months after surgery, the uncorrected near visual acuity of the operated eyes increased significantly from 0.55 ± 0.22 logMAR preoperatively to 0.25 ± 0.15 logMAR (p < 0.05) but mean bilateral uncorrected distant visual acuity did not change significantly (p = 0.90). Total higher-order aberration and spherical aberration increased, and the contrast sensitivity of the operated eyes decreased. Endothelial cell density and central corneal thickness did not change from preoperative values. Patient satisfaction for near vision was increased 6 months after implantation, and 50.0% of patients were independent of near spectacles. Explantation was done in 2 cases.ConclusionThe Flexivue Microlens refractive corneal inlay was effective for improving near visual acuity at 6 months follow-up But proportion of spectacle independency and patient satisfaction were lower in this Korean population than in previous reports. Further study with a longer follow-up period is needed.
Highlights
To evaluate the 6-month clinical outcomes of Flexivue Microlens refractive corneal inlay in emmetropic patients in Asia for the surgical compensation of presbyopia
They found that the mean bilateral uncorrected near visual acuity (UNVA) improved significantly to 0.13 logMAR, and the mean uncorrected distance visual acuity (UDVA) of the operated eyes decreased to 0.38 logMAR, though binocularly it did not change significantly
Because we present spherical aberration (SA) values using Zernike values, the direction of change must be interpreted differently from the values given in the previous study [20], but this change implies an extended depth of focus
Summary
To evaluate the 6-month clinical outcomes of Flexivue Microlens refractive corneal inlay in emmetropic patients in Asia for the surgical compensation of presbyopia. Corneal inlays are perceived to be minimally invasive, reversible, and safe [7], so several types of inlays have been developed, including the KAMRA (AcuFocus Inc., Irvine, CA, USA), Raindrop Near Vision Inlay (ReVision Optics, CA), and Flexivue Microlens (Presbia Coöperatief U.A., Irvine, CA, USA). Several studies have shown its effectiveness in increasing near visual acuity and its high patient satisfaction [8,9,10], and long-term follow-up studies reported stable results [11, 12]. Some surgeons have stopped implanting any intracorneal inlay for presbyopia because of wound healing concerns, unpredictable refractive outcomes, shifts in refractive errors, lens decentrations, and various optical side effects [17]
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