Small-aperture corneal inlay implantation to treat presbyopia after laser in situ keratomileusis

PURPOSE: To evaluate the visual outcomes after implantation of a Kamra small-aperture corneal inlay into a femtosecond-created corneal pocket to treat presbyopia in patients who had previous laser in situ keratomileusis (LASIK). SETTING: Private center, Tokyo, Japan. DESIGN: Prospective interventional case series. METHODS: Post-LASIK presbyopic patients had inlay implantation into a corneal pocket created by a femtosecond laser at a depth of 200 mu m or 250 mu m a minimum of 80 mu m below the previous LASIK flap interface in the nondonninant eye. Uncorrected and corrected distance visual acuities, near visual acuity, and a patient questionnaire on satisfaction, the use of reading glasses, and visual symptoms were evaluated. RESULTS: The study enrolled 223 eyes (223 patients) with a mean age of 53.6 years (range 44 to 65 years) and a mean manifest spherical equivalent of -0.18 diopter (D) (range -1.00 to +0.50 D). The mean uncorrected distance visual acuity in the operated eye decreased 1 line from 20/16 preoperatively to 20/20 6 months postoperatively (P<.001). The mean uncorrected near visual acuity improved 4 lines from Jaeger (J) 8 to J2 (P<.001). At 6 months, significant improvements were observed in patient dependence on reading glasses and patient satisfaction with vision without reading glasses. CONCLUSION: The 6-month results suggest that implantation of a small-aperture inlay in post-LASIK presbyopic patients improves near vision with a minimal effect on distance vision, resulting in high patient satisfaction and less dependence on reading glasses. (C) 2013 ASCRS and ESCRS