Implantable inlay devices for presbyopia: the evidence to date

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Abstract

By 2020, it is estimated that 2.1 billion people will be presbyopic, and the demand for spectacle independence in this group is growing. This review article provides an overview of the three commercially available corneal inlays for the correction of presbyopia. Safety, efficacy, visual outcomes, and complications are analyzed for all three inlays according to published peer-reviewed data.

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Most cited references 44

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Comparison of the IntraLase femtosecond laser and mechanical keratomes for laser in situ keratomileusis.

Karl G Stonecipher, Guy Kezirian (2004)

To compare laser in situ keratomileusis (LASIK) results obtained with the femtosecond laser (IntraLase Corp.) to those obtained using 2 popular mechanical microkeratomes. Private practice, Greensboro, North Carolina, USA. This retrospective analysis compared LASIK outcomes with the femtosecond laser to those with the Carriazo-Barraquer (CB) microkeratome (Moria, Inc.) and the Hansatome microkeratome (Bausch & Lomb, Inc.). The 3 groups were matched for enrollment criteria and were operated on under similar conditions by the same surgeon. There were 106 eyes in the IntraLase group, 126 eyes in the CB group, and 143 eyes in the Hansatome group. One day postoperatively, the uncorrected visual acuity (UCVA) results in the 3 groups were similar; at 3 months, the UCVA and the best spectacle-corrected visual acuity results were not significantly different. A manifest spheroequivalent of +/-0.50 diopter (D) was achieved in 91% of eyes in the IntraLase group, 73% of eyes in the CB group, and 74% of eyes in the Hansatome group (P<.01). IntraLase flaps were significantly thinner (P<.01) and varied less in thickness (P<.01) than flaps created with the other devices. The mean flap thickness was 114 microm +/- 14 (SD) with the IntraLase programmed for a 130 microm depth, 153 +/- 26 microm with the CB using a 130 microm plate, and 156 +/- 29 microm with the Hansatome using a 180 microm plate. Loose epithelium was encountered in 9.6% of eyes in the CB group and 7.7% of eyes in the Hansatome group but in no eye in the IntraLase group (P =.001). Surgically induced astigmatism in sphere corrections was significantly less with the IntraLase than with the other devices (P<.01). The IntraLase demonstrated more predictable flap thickness, better astigmatic neutrality, and decreased epithelial injury than 2 popular mechanical microkeratomes.

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Dry eye associated with laser in situ keratomileusis: Mechanical microkeratome versus femtosecond laser.

Marcella Q. Salomão, Renato Ambrósio, Steven E. Wilson (2009)

To compare the incidence of laser in situ keratomileusis (LASIK)-associated dry eye and the need for postoperative cyclosporine A treatment after flap creation with a femtosecond laser and a mechanical microkeratome. Cole Eye Institute, Cleveland, Ohio, USA. Eyes were randomized to flap creation with an IntraLase femtosecond laser (30 or 60 kHz) or a Hansatome microkeratome. No patient had signs, symptoms, or treatment of dry eye preoperatively. Flap thickness was determined by intraoperative ultrasonic pachymetry. Slitlamp assessments of the cornea and need for postoperative dry-eye treatment were evaluated preoperatively and 1 month postoperatively. The flap was created with the femtosecond laser in 113 eyes and with the microkeratome in 70 eyes. The difference in mean central flap thickness between the femtosecond group (111 mum +/- 14 [SD]) and the microkeratome group (131 +/- 25 mum) was statistically significant (P<.001). The incidence of LASIK-associated dry eye was statistically significantly higher in the microkeratome group (46%) than in the femtosecond group (8%) (P<.0001), as was the need for postoperative cyclosporine A treatment (24% and 7%, respectively) (P<.01). In the microkeratome group, there was no correlation between thick flaps and a higher incidence of LASIK-induced dry eye. Eyes with femtosecond flaps had a lower incidence of LASIK-associated dry eye and required less treatment for the disorder. In addition to neurotrophic effects from corneal nerve cutting, other factors may be important because no correlation was found between flap thickness (or ablation depth) and the incidence of LASIK-induced dry eye.

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Test-retest reliability of the CSV-1000 contrast test and its relationship to glaucoma therapy.

G Pomerance, William Evans (1994)

To determine the relationship between changes in contrast sensitivity, if any, after glaucoma therapy and the test-retest reliability of the CSV-1000 contrast sensitivity test. Patients with primary open angle glaucoma (N = 16) were retrospectively evaluated to determine changes in visual function, as measured by contrast sensitivity, after beta-blocker therapy. A control group (N = 24) of normally sighted patients was tested and retested on contrast sensitivity. For the control group, the coefficients of repeatability (95% confidence interval for test-retest variability [COR]) were calculated for each spatial frequency. The CORs were compared to the changes in vision found after therapy in the patients with glaucoma. The group with glaucoma showed a significant improvement (P < .01) in contrast sensitivity at all spatial frequencies. The test-retest variance for normals, as measured by the COR, was smaller than the mean differences in contrast sensitivity before and after therapy at all spatial frequencies, expect 18 cyc/deg. Visual function in patients with glaucoma, as measured by contrast sensitivity, does improve after beta-blocker therapy. Further, the CSV-1000 is a clinically reliable tool for monitoring these changes.

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Author and article information

Journal

Journal ID (nlm-ta): Clin Ophthalmol

Journal ID (iso-abbrev): Clin Ophthalmol

Journal ID (publisher-id): Clinical Ophthalmology

Title: Clinical Ophthalmology (Auckland, N.Z.)

Publisher: Dove Medical Press

ISSN (Print): 1177-5467

ISSN (Electronic): 1177-5483

Publication date Collection: 2015

Publication date (Electronic): 14 January 2015

Volume: 9

Pages: 129-137

Affiliations

Department of Ophthalmology, Paracelsus Medical University Salzburg, Salzburg, Austria

Author notes

Correspondence: Alois K Dexl, Department of Ophthalmology, Paracelsus Medical University Salzburg, Müllner Hauptstrasse 48, A 5020 Salzburg, Austria, Tel +43 662 4482 572 88, Fax +43 662 4482 3703, Email a.dexl@ 123456salk.at

Article

Publisher ID: opth-9-129

DOI: 10.2147/OPTH.S57056

PMC ID: 4298303

PubMed ID: 25609913

SO-VID: 16b4aaaa-4545-43d9-9e11-f0ead0054611

License:

The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

Implantable inlay devices for presbyopia: the evidence to date

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Karger: Ophthalmology

Most cited references 44

Comparison of the IntraLase femtosecond laser and mechanical keratomes for laser in situ keratomileusis.

Dry eye associated with laser in situ keratomileusis: Mechanical microkeratome versus femtosecond laser.

Test-retest reliability of the CSV-1000 contrast test and its relationship to glaucoma therapy.

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