1
|
Craig JP, Barsam A, Chen C, Chukwuemeka O, Ghorbani-Mojarrad N, Kretz F, Michaud L, Moore J, Pelosini L, Turnbull AMJ, Vincent SJ, Wang MTM, Ziaei M, Wolffsohn JS. BCLA CLEAR Presbyopia: Management with corneal techniques. Cont Lens Anterior Eye 2024:102190. [PMID: 38851946 DOI: 10.1016/j.clae.2024.102190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2024]
Abstract
Corneal techniques for enhancing near and intermediate vision to correct presbyopia include surgical and contact lens treatment modalities. Broad approaches used independently or in combination include correcting one eye for distant and the other for near or intermediate vision, (termed monovision or mini-monovision depending on the degree of anisometropia) and/or extending the eye's depth of focus [1]. This report provides an overview of the evidence for the treatment profile, safety, and efficacy of the range of corneal techniques currently available for managing presbyopia. The visual needs and expectations of the patient, their ocular characteristics, and prior history of surgery are critical considerations for patient selection and preoperative evaluation. Contraindications to refractive surgery include unstable refraction, corneal abnormalities, inadequate corneal thickness for the proposed ablation depth, ocular and systemic co-morbidities, uncontrolled mental health issues and unrealistic patient expectations. Laser refractive options for monovision include surface/stromal ablation techniques and keratorefractive lenticule extraction. Alteration of spherical aberration and multifocal ablation profiles are the primary means for increasing ocular depth of focus, using surface and non-surface laser refractive techniques. Corneal inlays use either small aperture optics to increase depth of field or modify the anterior corneal curvature to induce corneal multifocality. Presbyopia correction by conductive keratoplasty involves application of radiofrequency energy to the mid-peripheral corneal stroma which leads to mid-peripheral corneal shrinkage, inducing central corneal steepening. Hyperopic orthokeratology lens fitting can induce spherical aberration and correct some level of presbyopia. Postoperative management, and consideration of potential complications, varies according to technique applied and the time to restore corneal stability, but a minimum of 3 months of follow-up is recommended after corneal refractive procedures. Ongoing follow-up is important in orthokeratology and longer-term follow-up may be required in the event of late complications following corneal inlay surgery.
Collapse
Affiliation(s)
- Jennifer P Craig
- Department of Ophthalmology, Aotearoa New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand; College of Health & Life Sciences, Aston University, Birmingham, UK.
| | | | - Connie Chen
- Department of Optometry, Chung Shan Medical University, Taichung City, Taiwan
| | - Obinwanne Chukwuemeka
- Cornea, Contact Lens and Myopia Management Unit, De-Lens Ophthalmics Family and Vision Care Centre, Abuja, Nigeria
| | - Neema Ghorbani-Mojarrad
- School of Optometry and Vision Science, University of Bradford, Bradford, UK; Wolfson Centre for Applied Health Research, Bradford Royal Infirmary, Bradford, UK
| | | | | | | | | | - Andrew M J Turnbull
- Royal Bournemouth Hospital, University Hospitals Dorset, UK; Faculty of Life and Health Sciences, Ulster University, UK
| | - Stephen J Vincent
- Optometry and Vision Science, Centre for Vision and Eye Research, Queensland University of Technology, Brisbane, Australia
| | - Michael T M Wang
- Department of Ophthalmology, Aotearoa New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand
| | - Mohammed Ziaei
- Department of Ophthalmology, Aotearoa New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand
| | - James S Wolffsohn
- Department of Ophthalmology, Aotearoa New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand; College of Health & Life Sciences, Aston University, Birmingham, UK
| |
Collapse
|
2
|
Wolffsohn JS, Berkow D, Chan KY, Chaurasiya SK, Fadel D, Haddad M, Imane T, Jones L, Sheppard AL, Vianya-Estopa M, Walsh K, Woods J, Zeri F, Morgan PB. BCLA CLEAR Presbyopia: Evaluation and diagnosis. Cont Lens Anterior Eye 2024:102156. [PMID: 38641525 DOI: 10.1016/j.clae.2024.102156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2024]
Abstract
It is important to be able to measure the range of clear focus in clinical practice to advise on presbyopia correction techniques and to optimise the correction power. Both subjective and objective techniques are necessary: subjective techniques (such as patient reported outcome questionnaires and defocus curves) assess the impact of presbyopia on a patient and how the combination of residual objective accommodation and their natural DoF work for them; objective techniques (such as autorefraction, corneal topography and lens imaging) allow the clinician to understand how well a technique is working optically and whether it is the right choice or how adjustments can be made to optimise performance. Techniques to assess visual performance and adverse effects must be carefully conducted to gain a reliable end-point, considering the target size, contrast and illumination. Objective techniques are generally more reliable, can help to explain unexpected subjective results and imaging can be a powerful communication tool with patients. A clear diagnosis, excluding factors such as binocular vision issues or digital eye strain that can also cause similar symptoms, is critical for the patient to understand and adapt to presbyopia. Some corrective options are more permanent, such as implanted inlays / intraocular lenses or laser refractive surgery, so the optics can be trialled with contact lenses in advance (including differences between the eyes) to better communicate with the patient how the optics will work for them so they can make an informed choice.
Collapse
Affiliation(s)
- James S Wolffsohn
- School of Optometry, Health and Life Sciences, Aston University, Birmingham, United Kingdom.
| | - David Berkow
- Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel
| | - Ka Yin Chan
- Centre for Eye and Vision Research (CEVR), 17W Hong Kong Science Park, Hong Kong
| | - Suraj K Chaurasiya
- Department of Contact Lens and Anterior Segment, CL Gupta Eye Institute, Moradabad, India; Department of Optometry and Vision Science, CL Gupta Eye Institute, Moradabad, India
| | - Daddi Fadel
- Centre for Ocular Research & Education (CORE), School of Optometry & Vision Science, University of Waterloo, Waterloo, Canada
| | - Mera Haddad
- Faculty of Applied Medical Sciences, Department of Allied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Tarib Imane
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, College of Medicine, University of Illinois at Chicago, United States
| | - Lyndon Jones
- Centre for Eye and Vision Research (CEVR), 17W Hong Kong Science Park, Hong Kong; Centre for Ocular Research & Education (CORE), School of Optometry & Vision Science, University of Waterloo, Waterloo, Canada
| | - Amy L Sheppard
- School of Optometry, Health and Life Sciences, Aston University, Birmingham, United Kingdom
| | - Marta Vianya-Estopa
- Vision and Hearing Research Centre, Anglia Ruskin University, Cambridge, United Kingdom
| | - Karen Walsh
- CooperVision Inc., San Ramon, CA, United States
| | - Jill Woods
- Centre for Ocular Research & Education (CORE), School of Optometry & Vision Science, University of Waterloo, Waterloo, Canada
| | - Fabrizio Zeri
- School of Optometry, Health and Life Sciences, Aston University, Birmingham, United Kingdom; University of Milano-Bicocca, Department of Materials Science, Milan, Italy
| | - Philip B Morgan
- Eurolens Research, Division of Pharmacy and Optometry, University of Manchester, United Kingdom
| |
Collapse
|
3
|
Kummer O, Ogor F, Castignoles F, de Bougrenet de la Tocnaye JL, Nourrit V. Blazed photon sieve for the correction of presbyopia. OPTICS EXPRESS 2024; 32:396-407. [PMID: 38175070 DOI: 10.1364/oe.509300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 11/08/2023] [Indexed: 01/05/2024]
Abstract
What we believe to be a new type of transparent photon sieve is presented with application for presbyopia correction. Inspired by blazed gratings, we propose to design an intracorneal implant with slanted holes. The slopes introduce a new degree of freedom, breaking the symmetry of energy distribution along the optical axis and allowing to balance the energy between near and far vision. This new implant design is presented together with the simulation, manufacturing and validation methods. The first experimental results obtained with an implant manufactured in a biocompatible material are presented confirming the potential of the approach.
Collapse
|
4
|
Kohnen T, Lwowski C, Böhm M, Hemkeppler E, Jandewerth T. Visual Outcomes and Safety of a Refractive Corneal Inlay for Presbyopia: One-Year Results. J Refract Surg 2024; 40:e1-e9. [PMID: 38190559 DOI: 10.3928/1081597x-20231204-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2024]
Abstract
PURPOSE To determine the visual outcomes and safety 12 months after implantation of the Presbia Flexivue Microlens refractive corneal inlay. METHODS In this prospective, non-randomized trial, 22 patients with a mean age of 52.54 ± 2.86 years were implanted with the Flexivue Microlens refractive corneal inlay in the non-dominant eye at the Department of Ophthalmology, Goethe University, Frankfurt, Germany. Corrected near, intermediate, and distance (CNVA, CIVA, and CDVA) visual acuity and uncorrected near, intermediate, and distance (UNVA, UIVA, and UDVA) visual acuity, manifest refraction, subjective quality of vision, endothelial cell count, and contrast sensitivity were measured 1 day, 1 week, and 1, 3, 6, and 12 months postoperatively. RESULTS For binocular CDVA, no patient lost two or more lines and 30% lost only one line at the 12-month visit. In the eye that had surgery, 85% of the patients lost two or more lines of UDVA, which was statistically significant. Sixty-five percent of the patients gained one or more lines in binocular UIVA, and 80% achieved 20/40 or better in DCIVA. UNVA showed a statistically significant improvement, with 90% of the patients achieving 20/40 or better 12 months after implantation. A total of 85% gained two or more lines in binocular UNVA. CONCLUSIONS This refractive corneal inlay showed an improvement in binocular UNVA, UIVA, CNVA, and CIVA, whereas binocular CDVA and UDVA were not statistically affected. [J Refract Surg. 2024;40(1):e1-e9.].
Collapse
|
5
|
Li J, Moeinzadeh S, Kim C, Pan CC, Weale G, Kim S, Abrams G, James AW, Choo H, Chan C, Yang YP. Development and systematic characterization of GelMA/alginate/PEGDMA/xanthan gum hydrogel bioink system for extrusion bioprinting. Biomaterials 2023; 293:121969. [PMID: 36566553 PMCID: PMC9868087 DOI: 10.1016/j.biomaterials.2022.121969] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 07/27/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022]
Abstract
Gelatin methacryloyl (GelMA)/alginate-based hydrogels have shown great promise in bioprinting, but their printability is limited at room temperature. In this paper, we present our development of a room temperature printable hydrogel bioink by introducing polyethylene glycol dimethacrylate (PEGDMA) and xanthan gum into the GelMA/alginate system. The inclusion of PEGDMA facilitates tuning of the hydrogel's mechanical property, while xanthan gum improves the viscosity of the hydrogel system and allows easy extrusion at room temperature. To fine-tune the mechanical and degradation properties, methacrylated xanthan gum was synthesized and chemically crosslinked to the system. We systematically characterized this hydrogel with attention to printability, strut size, mechanical property, degradation and cytocompatibility, and achieved a broad range of compression modulus (∼10-100 kPa) and degradation profile (100% degradation by 24 h-40% by 2 weeks). Moreover, xanthan gum demonstrated solubility in ionic solutions such as cell culture medium, which is essential for biocompatibility. Live/dead staining showed that cell viability in the printed hydrogels was over 90% for 7 days. Metabolic activity analysis demonstrated excellent cell proliferation and survival within 4 weeks of incubation. In summary, the newly developed hydrogel system has demonstrated distinct features including extrusion printability, widely tunable mechanical property and degradation, ionic solubility, and cytocompatibility. It offers great flexibility in bioprinting and tissue engineering.
Collapse
Affiliation(s)
- Jiannan Li
- Department of Orthopaedic Surgery, Stanford University, 240 Pasteur Drive, Stanford, CA94304, USA
| | - Seyedsina Moeinzadeh
- Department of Orthopaedic Surgery, Stanford University, 240 Pasteur Drive, Stanford, CA94304, USA
| | - Carolyn Kim
- Department of Orthopaedic Surgery, Stanford University, 240 Pasteur Drive, Stanford, CA94304, USA; Department of Mechanical Engineering, Stanford University, 440 Escondido Mall, Stanford, CA94305, USA
| | - Chi-Chun Pan
- Department of Orthopaedic Surgery, Stanford University, 240 Pasteur Drive, Stanford, CA94304, USA; Department of Mechanical Engineering, Stanford University, 440 Escondido Mall, Stanford, CA94305, USA
| | - George Weale
- Department of Orthopaedic Surgery, Stanford University, 240 Pasteur Drive, Stanford, CA94304, USA
| | - Sungwoo Kim
- Department of Orthopaedic Surgery, Stanford University, 240 Pasteur Drive, Stanford, CA94304, USA
| | - Geoffrey Abrams
- Department of Orthopaedic Surgery, Stanford University, 240 Pasteur Drive, Stanford, CA94304, USA
| | - Aaron W James
- Department of Pathology, Johns Hopkins University, 720 Rutland Avenue, Room 524A, Baltimore, MD, 21205, USA
| | - HyeRan Choo
- Department of Surgery, Stanford University, 300 Pasteur Drive, Stanford, CA94305, USA
| | - Charles Chan
- Department of Surgery, Stanford University, 300 Pasteur Drive, Stanford, CA94305, USA
| | - Yunzhi Peter Yang
- Department of Orthopaedic Surgery, Stanford University, 240 Pasteur Drive, Stanford, CA94304, USA; Department of Materials Science and Engineering, Stanford University, 496 Lomita Mall, Stanford, CA94305, USA; Department of Bioengineering, Stanford University, 443 Via Ortega, Stanford, CA94305, USA.
| |
Collapse
|
6
|
Hu X, Wei R, Liu C, Wang Y, Yang D, Sun L, Xia F, Liu S, Li M, Zhou X. Recent advances in small incision lenticule extraction (SMILE)-derived refractive lenticule preservation and clinical reuse. ENGINEERED REGENERATION 2023. [DOI: 10.1016/j.engreg.2023.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
|
7
|
Presbyopic Corneal Inlay Extrusion Consequent to Sterile Keratolysis: Surgical Revision and Long-Term Management. Cornea 2022; 41:1564-1567. [PMID: 35942531 DOI: 10.1097/ico.0000000000002982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 11/30/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE The purpose of this study was to report a serious complication of early sterile keratolysis associated with a presbyopia inlay implantation combined with hyperopic laser in situ keratomileusis (LASIK). METHODS A 55-year-old hyperopic man underwent uneventful topography-guided bilateral femtosecond laser-assisted hyperopic LASIK, combined with same-day polymer refractive inlay implantation in the nondominant eye for additional presbyopia correction. Within 2 months, anterior sterile keratolysis and partial extrusion required surgical explantation of the inlay, and long-term medical management over 9 years achieved effective visual rehabilitation documented also with corneal imaging. RESULTS Immediate postoperative results were binocular 20/20 uncorrected distance visual acuity and J1 uncorrected near visual acuity. The early progressive anterior sterile keratolysis and partial extrusion necessitated surgical explantation at 2 months, severe anterior scarring of the perforated flap area and severe focal flattening of the cornea of over 10 diopters, developed despite aggressive topical corticosteroid use. The uncorrected distance visual acuity in the OS dropped from 20/25 to 20/400. The LASIK flap portion that underwent keratolysis and perforated, remodeled long-term from a scarred, epithelial plug with early significant surface concavity to evidently a mild subepithelial localized hazy area with regularized curvature over a period of 9 years. CONCLUSIONS Some refractive synthetic corneal inlays have been recalled because they may result in significant corneal haze. We present herein a case of severe keratolysis that necessitated surgical explantation and further document long-term care for eventual visual rehabilitation.
Collapse
|
8
|
Affiliation(s)
- Samir Jabbour
- Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Kraig S Bower
- Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, Maryland
| |
Collapse
|
9
|
Abstract
Presbyopia is a growing problem in view of an aging global population and increasingly patients desire spectacle-free solutions to address this condition. Surgically implanted corneal inlays have been the topic of renewed research efforts in the past several years as a treatment option for presbyopia, with several approaches being used to modify the refractive properties of the cornea and enhance near vision. In this review we discuss historical approaches to corneal inlay surgery, critically appraise the current generation of presbyopia-correcting corneal inlays and their associated complications and consider the future prospects for emerging corneal inlay technologies that aim address the shortcomings of currently available inlays.
Collapse
|
10
|
Ang M, Gatinel D, Reinstein DZ, Mertens E, Alió Del Barrio JL, Alió JL. Refractive surgery beyond 2020. Eye (Lond) 2020; 35:362-382. [PMID: 32709958 DOI: 10.1038/s41433-020-1096-5] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 05/19/2020] [Accepted: 07/08/2020] [Indexed: 02/07/2023] Open
Abstract
Refractive surgery refers to any procedure that corrects or minimizes refractive errors. Today, refractive surgery has evolved beyond the traditional laser refractive surgery, embodied by the popular laser in situ keratomileusis or 'LASIK'. New keratorefractive techniques such as small incision lenticule extraction (SMILE) avoids corneal flap creation and uses a single laser device, while advances in surface ablation techniques have seen a resurgence in its popularity. Presbyopic treatment options have also expanded to include new ablation profiles, intracorneal implants, and phakic intraocular implants. With the improved safety and efficacy of refractive lens exchange, a wider variety of intraocular lens implants with advanced optics provide more options for refractive correction in carefully selected patients. In this review, we also discuss possible developments in refractive surgery beyond 2020, such as preoperative evaluation of refractive patients using machine learning and artificial intelligence, potential use of stromal lenticules harvested from SMILE for presbyopic treatments, and various advances in intraocular lens implants that may provide a closer to 'physiological correction' of refractive errors.
Collapse
Affiliation(s)
- Marcus Ang
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore. .,Department of Ophthalmology and Visual Science, Duke-NUS Graduate Medical School, Singapore, Singapore.
| | | | - Dan Z Reinstein
- London Vision Clinic, London, UK.,Department of Ophthalmology, Columbia University Medical Center, New York, NY, USA.,Sorbonne Université, Paris, France.,Biomedical Science Research Institute, Ulster University, Belfast, UK
| | - Erik Mertens
- Medipolis-Antwerp Private Clinic, Antwerp, Belgium
| | - Jorge L Alió Del Barrio
- Division of Ophthalmology, School of Medicine, Universidad Miguel Hernández, Alicante, Spain.,Cornea, Cataract and Refractive Surgery Unit, Vissum (Miranza Group), Alicante, Spain
| | - Jorge L Alió
- Division of Ophthalmology, School of Medicine, Universidad Miguel Hernández, Alicante, Spain.,Cornea, Cataract and Refractive Surgery Unit, Vissum (Miranza Group), Alicante, Spain
| |
Collapse
|
11
|
Riau AK, Liu YC, Yam GH, Mehta JS. Stromal keratophakia: Corneal inlay implantation. Prog Retin Eye Res 2020; 75:100780. [DOI: 10.1016/j.preteyeres.2019.100780] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 07/28/2019] [Accepted: 09/02/2019] [Indexed: 12/31/2022]
|
12
|
Steinert RF, Koch DD, Cochener B, Lang A, Barragán-Garza E, Chayet A, Vargas LG. Corneal remodeling after implantation of a shape-changing inlay concurrent with myopic or hyperopic laser in situ keratomileusis. J Cataract Refract Surg 2019; 43:1443-1449. [PMID: 29223234 DOI: 10.1016/j.jcrs.2017.07.036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 06/15/2017] [Accepted: 07/30/2017] [Indexed: 11/25/2022]
Abstract
PURPOSE To compare the induced addition (add)-power profile and epithelial remodeling between patients receiving hyperopic and myopic laser in situ keratomileusis (LASIK) concurrently with implantation of a corneal shape-changing inlay. SETTING Specialty clinics in Monterrey and Tijuana, Mexico. DESIGN Retrospective case series. METHODS Preoperative hyperopic patients (mean spherical equivalent [SE] treatment +1.71 diopters [D] ± 0.51 [SD]) and myopic patients (mean SE treatment -2.48 ± 1.33 D) had implantation of a Raindrop Near Vision Inlay in the nondominant eye immediately after the excimer laser ablation in both eyes under a corneal flap. Monocular and binocular visual acuities were recorded at 6 m. Wavefront measurement analysis yielded the mean inlay add-power profile, and optical coherence tomography images yielded the mean epithelial remodeling profile. RESULTS In the inlay eye in the hyperopic group (n = 34) and myopic group (n = 29), the mean uncorrected near visual acuity exceeded 20/25 (85% 20/25 or better), the mean uncorrected distance visual acuity (UDVA) was 20/32 (62% 20/32 or better), and the mean binocular UDVA was 20/18 (100% 20/25 or better). The add-power profiles for the hyperopic and myopic groups were similar. The epithelial thinning profiles were also the same, thinning centrally by approximately 19 μm, and were uncorrelated with the treated refractive error. CONCLUSIONS After concurrent LASIK and inlay implantation, the visual acuity, induced add-power profile, and epithelial remodeling were the same, regardless of hyperopic or myopic treatment.
Collapse
Affiliation(s)
- Roger F Steinert
- From the Gavin Herbert Eye Institute (Steinert), University of California, Irvine, Revision Optics, Inc. (Lang, Vargas), Lake Forest, California, and the Department of Ophthalmology (Koch), Baylor College of Medicine, Houston, Texas, USA; Centre Hospitalier Universitaire de Brest (Cochener), Brest Cedex, France; Laser Ocular Hidalgo (Barragán-Garza), Monterrey, and Codet Vision (Chayet), Tijuana, Mexico
| | - Douglas D Koch
- From the Gavin Herbert Eye Institute (Steinert), University of California, Irvine, Revision Optics, Inc. (Lang, Vargas), Lake Forest, California, and the Department of Ophthalmology (Koch), Baylor College of Medicine, Houston, Texas, USA; Centre Hospitalier Universitaire de Brest (Cochener), Brest Cedex, France; Laser Ocular Hidalgo (Barragán-Garza), Monterrey, and Codet Vision (Chayet), Tijuana, Mexico
| | - Beatrice Cochener
- From the Gavin Herbert Eye Institute (Steinert), University of California, Irvine, Revision Optics, Inc. (Lang, Vargas), Lake Forest, California, and the Department of Ophthalmology (Koch), Baylor College of Medicine, Houston, Texas, USA; Centre Hospitalier Universitaire de Brest (Cochener), Brest Cedex, France; Laser Ocular Hidalgo (Barragán-Garza), Monterrey, and Codet Vision (Chayet), Tijuana, Mexico
| | - Alan Lang
- From the Gavin Herbert Eye Institute (Steinert), University of California, Irvine, Revision Optics, Inc. (Lang, Vargas), Lake Forest, California, and the Department of Ophthalmology (Koch), Baylor College of Medicine, Houston, Texas, USA; Centre Hospitalier Universitaire de Brest (Cochener), Brest Cedex, France; Laser Ocular Hidalgo (Barragán-Garza), Monterrey, and Codet Vision (Chayet), Tijuana, Mexico
| | - Enrique Barragán-Garza
- From the Gavin Herbert Eye Institute (Steinert), University of California, Irvine, Revision Optics, Inc. (Lang, Vargas), Lake Forest, California, and the Department of Ophthalmology (Koch), Baylor College of Medicine, Houston, Texas, USA; Centre Hospitalier Universitaire de Brest (Cochener), Brest Cedex, France; Laser Ocular Hidalgo (Barragán-Garza), Monterrey, and Codet Vision (Chayet), Tijuana, Mexico
| | - Arturo Chayet
- From the Gavin Herbert Eye Institute (Steinert), University of California, Irvine, Revision Optics, Inc. (Lang, Vargas), Lake Forest, California, and the Department of Ophthalmology (Koch), Baylor College of Medicine, Houston, Texas, USA; Centre Hospitalier Universitaire de Brest (Cochener), Brest Cedex, France; Laser Ocular Hidalgo (Barragán-Garza), Monterrey, and Codet Vision (Chayet), Tijuana, Mexico
| | - Luis G Vargas
- From the Gavin Herbert Eye Institute (Steinert), University of California, Irvine, Revision Optics, Inc. (Lang, Vargas), Lake Forest, California, and the Department of Ophthalmology (Koch), Baylor College of Medicine, Houston, Texas, USA; Centre Hospitalier Universitaire de Brest (Cochener), Brest Cedex, France; Laser Ocular Hidalgo (Barragán-Garza), Monterrey, and Codet Vision (Chayet), Tijuana, Mexico.
| |
Collapse
|
13
|
Bidaguren A, Mendicute J, Madarieta I, Garagorri N. Confocal and Histological Features After Poly(Ethylene Glycol) Diacrylate Corneal Inlay Implantation. Transl Vis Sci Technol 2019; 8:39. [PMID: 31867140 PMCID: PMC6922274 DOI: 10.1167/tvst.8.6.39] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 10/24/2019] [Indexed: 11/24/2022] Open
Abstract
Purpose To evaluate the in vivo biocompatibility of photopolymerized poly(ethylene glycol) diacrylate (PEGDA) intrastromal inlays in rabbit corneas. Methods Sixty-three eyes of 42 New Zealand rabbits were included. Manual intrastromal pockets were dissected in 42 eyes. PEGDA inlays were obtained using a specifically designed photomask and were inserted in the intrastromal pocket of 21 eyes (inlay group); the remaining 21 right eyes did not receive any implant (pocket-only group). Twenty-one eyes with no intervention were used as controls. In vivo confocal microscopy (IVCM) was performed at every visit. After 2 months, rabbits were sacrificed and corneas removed for histological analysis. Results Corneas remained clear in all but two animals, and five cases of corneal neovascularization were seen (P = 0.2). Inlays remained stable without evidence of lateral or anterior migration, and no other complications were observed. No changes in anterior and posterior keratocyte density (P = 0.3 and P = 0.1, respectively) or endothelial cell density (P = 0.23) were observed between groups during the study time by IVCM. On pathology samples, thinning of the epithelium over the inlay area and epithelial hyperplasia over the edges were observed. A polygonal empty space with no evidence of PEGDA hydrogel within the midstroma was seen in the inlay group. Keratocytes were normal in shape and number in the vicinity of the PEGDA implant area. Conclusions Photopolymerized PEGDA intrastromal inlays have shown relatively good safety and stability in rabbit corneas. Inlays were biostable in the corneal environment and remained transparent during follow up. Translational Relevance The investigated PEGDA is promising for the development of biocompatible intrastromal implants.
Collapse
|
14
|
Harb WG, Chamoun NG, Harb GW. KAMRA Inlay Implantation for Presbyopia Compensation: A Retrospective Evaluation of Patient Satisfaction and Subjective Vision 12-Month Postoperative. Middle East Afr J Ophthalmol 2019; 26:65-70. [PMID: 31543662 PMCID: PMC6737781 DOI: 10.4103/meajo.meajo_159_16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE: The aim of the study is to evaluate patients' satisfaction and subjective vision 12 months after monocular KAMRA corneal inlay implantation for the surgical compensation of presbyopia. SUBJECTS AND METHODS: Medical records of patients who underwent corneal inlay implantation in the nondominant eye between 2013 and 2014 were retrospectively reviewed. Data were collected from several centers in Lebanon. Patients with hyperopia or myopia with presbyopia between 45 and 70 years not suffering from any other ocular pathology were eligible for inclusion. Twelve-month postoperative satisfaction score was evaluated in all patients as well as the subjective vision score for near, intermediate, and distant tasks. RESULTS: This study included 73 patients. Almost 95% (69/73) of patients were satisfied or very satisfied with their vision and 93% (68/73) never or almost never used reading glasses while performing daily tasks. Subjective vision scores were found to be higher for distant and intermediate tasks performed during the day than for those performed during the night (P < 0.001). The average subjective vision score for reading a book or a newspaper in dim light was the lowest among all average subjective vision scores. No difference in satisfaction was found between patients with myopia or hyperopia or between males and females. CONCLUSION: The implant of a small-aperture corneal inlay resulted in a substantial improvement in patients' distant, intermediate, and near subjective vision, better in normal light than in dim light, and most patients became spectacles independent.
Collapse
Affiliation(s)
- Walid G Harb
- Department of Ophthalmology, Lebanese University, Beirut, Lebanon.,Department of Ophthalmology, Holy Spirit University Kaslik, Jounieh, Lebanon.,Department of Ophthalmology, CHU-Name de Secours Jbeil, Byblos, Lebanon.,Department of Ophthalmology, French Hospital of the Levant, Metn, Lebanon
| | - Nabil G Chamoun
- Department of Ophthalmology, French Hospital of the Levant, Metn, Lebanon
| | - Georges W Harb
- Department of Ophthalmology, French Hospital of the Levant, Metn, Lebanon
| |
Collapse
|
15
|
Paley GL, Harocopos GJ. Histopathologic Analysis of Explanted KAMRA Corneal Inlays Demonstrating Adherent Fibroconnective Tissue Scar Formation. Ocul Oncol Pathol 2019; 5:440-444. [PMID: 31768368 DOI: 10.1159/000498944] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 02/11/2019] [Indexed: 12/27/2022] Open
Abstract
Objective To investigate the histologic composition of opaque membranes associated with corneal intrastromal inlays implanted for the surgical treatment of presbyopia. Methods This is an observational case series of KAMRA corneal inlays explanted due to the presence of adherent opaque membranes associated with peri-inlay corneal stromal haze and sent for histopathologic analysis. Routine histology was performed in addition to immunohistochemical staining with myofibroblast and keratocyte markers. Results Eleven explanted inlay specimens were received, of which, after histologic processing, four demonstrated suf-ficient cellular material for histopathologic analysis. The opaque membranes surrounding the explanted inlays were composed of fibroconnective tissue, and myofibroblasts (positive for smooth muscle actin immunostain) were the predominant cell type. Immunostaining for the keratocyte marker CD34 was negative, confirming that the membranes were the result of a reactive scar-tissue formation process and not simply normal corneal stroma adherent to the explant. Conclusions Corneal inlay implantation can lead to the formation of an adherent fibroconnective tissue membrane, suggesting keratocyte-to-myofibroblast transdifferentiation and reactive fibroconnective tissue scar formation that could potentially impact visual potential. Prospective patients should be counseled regarding the risk of this complication, as this may be associated with some risk of incomplete reversibility of the procedure.
Collapse
Affiliation(s)
- Grace L Paley
- Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, Missouri, USA
| | - George J Harocopos
- Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, Missouri, USA.,Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri, USA
| |
Collapse
|
16
|
Albou-Ganem C. [Presbyopia and refractive surgery]. J Fr Ophtalmol 2019; 42:790-798. [PMID: 30857805 DOI: 10.1016/j.jfo.2018.08.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Accepted: 08/27/2018] [Indexed: 01/19/2023]
Abstract
Presbyopia is the progressive loss of accommodation. Accommodation is a quick, precise and involuntary action which enables the eye to change the power of the young crystalline lens to see clearly at all distances. Presbyopia is and age-linked physiologic phenomenon: it results from aging of the lens, which loses its elasticity, gradually becomes rigid and loses the ability to accommodate. Presbyopia has attained a prevalence of 80% in Europe and is increasing regularly due to the aging of the population. Various surgical techniques can be proposed. Indications depend on age, ophthalmological exam, and any associated ametropia. The main techniques act by either changing the curvature of the cornea with laser or with an intrastromal inlay to create pseudoaccomodation, or by intraocular lens surgery with a multifocal or accommodating IOL. Once the surgical choice has been made, the information must be clearly conveyed and consent obtained.
Collapse
Affiliation(s)
- C Albou-Ganem
- Appartenance clinique de la vision, 230, rue du Fg St Honoré, 75008 Paris, France.
| |
Collapse
|
17
|
Fenner BJ, Liu YC, Koh SK, Gao Y, Deng L, Beuerman RW, Zhou L, Theng JTS, Mehta JS. Mediators of Corneal Haze Following Implantation of Presbyopic Corneal Inlays. ACTA ACUST UNITED AC 2019; 60:868-876. [DOI: 10.1167/iovs.18-25761] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Beau J. Fenner
- Singapore National Eye Centre, Singapore
- Singapore Eye Research Institute, Singapore
| | - Yu-Chi Liu
- Singapore National Eye Centre, Singapore
- Singapore Eye Research Institute, Singapore
- Eye Academic Clinical Program, Duke-NUS Graduate Medical School, Singapore
| | | | - Yan Gao
- Singapore Eye Research Institute, Singapore
| | - Lu Deng
- Department of Statistics and Applied Probability, National University of Singapore
| | - Roger W. Beuerman
- Singapore Eye Research Institute, Singapore
- Eye Academic Clinical Program, Duke-NUS Graduate Medical School, Singapore
- Neuroscience Signature Research Program, Duke-NUS Graduate Medical School, Singapore
| | - Lei Zhou
- Singapore Eye Research Institute, Singapore
- Eye Academic Clinical Program, Duke-NUS Graduate Medical School, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | - Jodhbir S. Mehta
- Singapore National Eye Centre, Singapore
- Singapore Eye Research Institute, Singapore
- Eye Academic Clinical Program, Duke-NUS Graduate Medical School, Singapore
| |
Collapse
|
18
|
Wolffsohn JS, Davies LN. Presbyopia: Effectiveness of correction strategies. Prog Retin Eye Res 2018; 68:124-143. [PMID: 30244049 DOI: 10.1016/j.preteyeres.2018.09.004] [Citation(s) in RCA: 132] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2018] [Revised: 09/14/2018] [Accepted: 09/18/2018] [Indexed: 01/04/2023]
Abstract
Presbyopia is a global problem affecting over a billion people worldwide. The prevalence of unmanaged presbyopia is as high as 50% of those over 50 years of age in developing world populations, due to a lack of awareness and accessibility to affordable treatment, and is even as high as 34% in developed countries. Definitions of presbyopia are inconsistent and varied, so we propose a redefinition that states "presbyopia occurs when the physiologically normal age-related reduction in the eye's focusing range reaches a point, when optimally corrected for distance vision, that the clarity of vision at near is insufficient to satisfy an individual's requirements". Strategies for correcting presbyopia include separate optical devices located in front of the visual system (reading glasses) or a change in the direction of gaze to view through optical zones of different optical powers (bifocal, trifocal or progressive addition spectacle lenses), monovision (with contact lenses, intraocular lenses, laser refractive surgery and corneal collagen shrinkage), simultaneous images (with contact lenses, intraocular lenses and corneal inlays), pinhole depth of focus expansion (with intraocular lenses, corneal inlays and pharmaceuticals), crystalline lens softening (with lasers or pharmaceuticals) or restored dynamics (with 'accommodating' intraocular lenses, scleral expansion techniques and ciliary muscle electrostimulation); these strategies may be applied differently to the two eyes to optimise the range of clear focus for an individual's task requirements and minimise adverse visual effects. However, none fully overcome presbyopia in all patients. While the restoration of natural accommodation or an equivalent remains elusive, guidance is given on presbyopic correction evaluation techniques.
Collapse
Affiliation(s)
- James S Wolffsohn
- Ophthalmic Research Group, Life and Health Sciences, Aston University, Birmingham, B4 7ET, UK.
| | - Leon N Davies
- Ophthalmic Research Group, Life and Health Sciences, Aston University, Birmingham, B4 7ET, UK
| |
Collapse
|
19
|
Cálculo de lente intraocular en un paciente con antecedente de cirugía LASIK bilateral y colocación de implante intracorneal para presbicia. REVISTA MEXICANA DE OFTALMOLOGÍA 2018. [DOI: 10.1016/j.mexoft.2016.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
|
20
|
Vukich JA, Durrie DS, Pepose JS, Thompson V, van de Pol C, Lin L. Evaluation of the small-aperture intracorneal inlay: Three-year results from the cohort of the U.S. Food and Drug Administration clinical trial. J Cataract Refract Surg 2018; 44:541-556. [DOI: 10.1016/j.jcrs.2018.02.023] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 02/20/2018] [Accepted: 02/28/2018] [Indexed: 10/16/2022]
|
21
|
Chu R, Lee BR. Diagnostic and Management Tool for Monitoring Patients Implanted with a Shape-Changing Corneal Inlay. Case Rep Ophthalmol 2018; 9:190-196. [PMID: 29681835 PMCID: PMC5903103 DOI: 10.1159/000484436] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Accepted: 10/11/2017] [Indexed: 11/19/2022] Open
Abstract
We report two cases that underwent corneal inlay implantation under a femtosecond flap. The first case had no complications during the postoperative period. Pentacam maps remained stable over time: corneal densitometry (CD) values had less than 2 units of change across visits up to 3 years. Axial/sagittal topography maps showed a stable Kmax (∼47 D), i.e., less than 1 D change between visits. The second case developed haze at 8 months postoperatively. CD increased by more than 4 units from 3 to 8 M and Kmax increased by 2.6 D. The patient was prescribed steroids and 1 month later the haze regressed, resulting in pre-haze CD and Kmax values, similar to the ones at 3 months.
Collapse
Affiliation(s)
- Ralph Chu
- Chu Vision Institute, Bloomington, Minnesota, USA
| | - Briana R Lee
- ReVision Optics Inc., Lake Forest, California, USA
| |
Collapse
|
22
|
Barragán-Garza E, Koch DD, Vargas LG, Lang A, Roy A. The Sensitivity of Clinical Outcomes to Centration on the Light-Constricted Pupil for a Shape-Changing Corneal Inlay. J Refract Surg 2018. [PMID: 29522225 DOI: 10.3928/1081597x-20180103-02] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To assess the clinically acceptable range of inlay decentration with respect to the light-constricted pupil center and the coaxially sighted corneal light reflex (CSCLR) for an inlay (Raindrop Near Vision Inlay; ReVision Optics, Inc., Lake Forest, CA) that reshapes the anterior corneal surface. METHODS In this retrospective, observational cohort study of 115 patients with emmetropic or low hyperopic presbyopia who were implanted with a shape-changing corneal inlay, visual acuity, task performance (in good and dim light), reports of halos and glare, and satisfaction data were collected from the preoperative and 3-month postoperative examinations. Inlay centration with respect to the pupil center and CSCLR was determined from the center of the inlay effect derived from iTrace (Tracey Technologies, Houston, TX) wavefront measurements. Multivariate regression models assessed the influence of inlay position on visual outcomes. RESULTS On average, monocular uncorrected near visual acuity (UNVA) improved 4.9 ± 1.7 lines in the treated eye, with no loss in binocular distance vision. Eighty-three percent of implants were centered radially within 0.5 mm of the pupil center. Multivariate analysis of decentration with respect to both the pupil center and CSCLR revealed no significant interaction with the above clinical outcomes, with the exception of UNVA in the treated eye (all P > .05, α = 0.05). For decentration of less than 0.75 mm, the change in UNVA was less than 1 line. CONCLUSIONS Distance and near visual acuity, task performance, severity of halos and glare, and satisfaction were independent of radial decentration of the Raindrop Near Vision Inlay of less than 0.75 mm from the light-constricted pupil. [J Refract Surg. 2018;34(3):164-170.].
Collapse
|
23
|
Liu YC, Teo EPW, Ang HP, Seah XY, Lwin NC, Yam GHF, Mehta JS. Biological corneal inlay for presbyopia derived from small incision lenticule extraction (SMILE). Sci Rep 2018; 8:1831. [PMID: 29382905 PMCID: PMC5789881 DOI: 10.1038/s41598-018-20267-7] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 01/15/2018] [Indexed: 01/06/2023] Open
Abstract
Corneal inlays are a relatively new treatment option for presbyopia. Using biological inlays, derived from lenticules extracted from small incision lenticule extraction, may offer advantages over commercialized synthetic inlays in the aspect of biocompatibility. We conducted a non-human primate study to evaluate the safety, predictability, efficacy and tissue response after autogeneic, decellularized xenogeneic and xenogeneic lenticule implantation. The lenticule implantation effectively resulted in central corneal steepening (simulated keratometric values increased by 1.8–2.3 diopters), central hyper-prolate changes (asphericity Q values changed by −0.26 to −0.36), corneal anterior surface elevation (7.7–9.3 μm) and reasonable effective zone (1.5–1.8 times of the lenticule physical diameter), with no differences among the three groups. Slit lamp microscopy, transmission electron microscopy, confocal microscopy, histology and immunohistochemistry analyses confirmed the biocompatibility of the autogeneic and decellularized lenticules, whereas one eye in the xenogeneic group developed corneal stromal rejection during the study period. Our results showed that lenticule implantation has the potential for the management of presbyopia, and provide the basis for future clinical studies. The decellularization process may increase the potential utilization of lenticules without changing the efficacy.
Collapse
Affiliation(s)
- Yu-Chi Liu
- Tissue Engineering and Stem Cell Group, Singapore Eye Research Institute, Singapore, Singapore.,Singapore National Eye Centre, Singapore, Singapore.,Duke-NUS Graduate Medical School, Singapore, Singapore
| | - Ericia Pei Wen Teo
- Tissue Engineering and Stem Cell Group, Singapore Eye Research Institute, Singapore, Singapore
| | - Heng Pei Ang
- Tissue Engineering and Stem Cell Group, Singapore Eye Research Institute, Singapore, Singapore
| | - Xin Yi Seah
- Tissue Engineering and Stem Cell Group, Singapore Eye Research Institute, Singapore, Singapore
| | - Nyein Chan Lwin
- Tissue Engineering and Stem Cell Group, Singapore Eye Research Institute, Singapore, Singapore
| | - Gary Hin Fai Yam
- Tissue Engineering and Stem Cell Group, Singapore Eye Research Institute, Singapore, Singapore
| | - Jodhbir S Mehta
- Tissue Engineering and Stem Cell Group, Singapore Eye Research Institute, Singapore, Singapore. .,Singapore National Eye Centre, Singapore, Singapore. .,Duke-NUS Graduate Medical School, Singapore, Singapore. .,School of Material Science & Engineering and School of Mechanical and Aerospace Engineering, Nanyang Technological University, Singapore, Singapore.
| |
Collapse
|
24
|
Balgos MJTD, Vargas V, Alió JL. Correction of presbyopia: An integrated update for the practical surgeon. Taiwan J Ophthalmol 2018; 8:121-140. [PMID: 30294526 PMCID: PMC6169332 DOI: 10.4103/tjo.tjo_53_18] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Presbyopia results from loss or insufficiency of the eye's accommodative ability, and clinically manifests as the inability to focus near objects on the retina. It is one of the most common causes of visual impairment worldwide especially in adults of productive or working age. Various means of compensating for the loss of accommodative ability have been devised from optical tools such as spectacles and contact lenses, to topical medications and to surgical procedures. A comprehensive search on journal articles about topical and surgical correction of presbyopia was undertaken. The various techniques for presbyopia correction, as enumerated in these articles, are discussed in this paper with the addition of our personal experience and perspective on the future of these techniques.
Collapse
Affiliation(s)
| | | | - Jorge L Alió
- VISSUM Alicante, Spain.,Division of Ophthalmology, Universidad Miguel Hernández, Spain
| |
Collapse
|
25
|
Refractive Errors & Refractive Surgery Preferred Practice Pattern®. Ophthalmology 2018; 125:P1-P104. [DOI: 10.1016/j.ophtha.2017.10.003] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 10/02/2017] [Indexed: 11/19/2022] Open
|
26
|
Verdoorn C. Comparison of a hydrogel corneal inlay and monovision laser in situ keratomileusis in presbyopic patients: focus on visual performance and optical quality. Clin Ophthalmol 2017; 11:1727-1734. [PMID: 29033538 PMCID: PMC5614777 DOI: 10.2147/opth.s142075] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To compare the visual performance and optical quality after Raindrop Near Vision Inlay implantation or monovision LASIK for the correction of presbyopia. MATERIALS AND METHODS In this retrospective case-series study, patients previously treated in the nondominant eye with monovision LASIK were compared with patients previously implanted with Raindrop Near Vision Inlay. The study enrolled 16 inlay and 15 monovision LASIK patients. Uncorrected near visual acuity, uncorrected distance visual acuity, binocular stereopsis, patient satisfaction, and patient task performance were assessed. RESULTS Postoperatively, the mean spherical equivalent was -0.66 D (0.78 SD) for the inlay group and -1.03 D (0.56 SD) for the monovision LASIK group. Monocularly, at uncorrected near distances, 60% of inlay patients and 47% of monovision LASIK patients achieved ≥20/20. Monocularly, at uncorrected far distances, 75% of inlay patients and 40% of monovision LASIK patients achieved ≥20/32 vision. Binocularly, at near distances, 79% of inlay patients and 53% of monovision LASIK patients obtained ≥20/20 vision. All patients achieved ≥20/20 binocularly for distance. On average, inlay patients obtained 98 seconds of arc and monovision LASIK patients obtained 286 seconds of arc for stereopsis. Most (79%) of the inlay patients and 66% of monovision LASIK patients were satisfied with their near vision, while 86% of inlay patients and 67% of monovision LASIK patients were satisfied with their distance vision. CONCLUSION Patients receiving corneal inlays demonstrated better near and distance visual acuities, binocular stereopsis, task performance, and satisfaction, when compared to patients treated with monovision LASIK.
Collapse
|
27
|
|
28
|
Ralph Chu Y, Heckman J, Harrie M. Intracorneal Inlays for Presbyopia. CURRENT OPHTHALMOLOGY REPORTS 2017. [DOI: 10.1007/s40135-017-0146-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
29
|
Gomes JAP, Azar DT, Baudouin C, Efron N, Hirayama M, Horwath-Winter J, Kim T, Mehta JS, Messmer EM, Pepose JS, Sangwan VS, Weiner AL, Wilson SE, Wolffsohn JS. TFOS DEWS II iatrogenic report. Ocul Surf 2017; 15:511-538. [PMID: 28736341 DOI: 10.1016/j.jtos.2017.05.004] [Citation(s) in RCA: 247] [Impact Index Per Article: 35.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2017] [Accepted: 05/02/2017] [Indexed: 01/04/2023]
Abstract
Dry eye can be caused by a variety of iatrogenic interventions. The increasing number of patients looking for eye care or cosmetic procedures involving the eyes, together with a better understanding of the pathophysiological mechanisms of dry eye disease (DED), have led to the need for a specific report about iatrogenic dry eye within the TFOS DEWS II. Topical medications can cause DED due to their allergic, toxic and immuno-inflammatory effects on the ocular surface. Preservatives, such as benzalkonium chloride, may further aggravate DED. A variety of systemic drugs can also induce DED secondary to multiple mechanisms. Moreover, the use of contact lens induces or is associated with DED. However, one of the most emblematic situations is DED caused by surgical procedures such as corneal refractive surgery as in laser-assisted in situ keratomileusis (LASIK) and keratoplasty due to mechanisms intrinsic to the procedure (i.e. corneal nerve cutting) or even by the use of postoperative topical drugs. Cataract surgery, lid surgeries, botulinum toxin application and cosmetic procedures are also considered risk factors to iatrogenic DED, which can cause patient dissatisfaction, visual disturbance and poor surgical outcomes. This report also presents future directions to address iatrogenic DED, including the need for more in-depth epidemiological studies about the risk factors, development of less toxic medications and preservatives, as well as new techniques for less invasive eye surgeries. Novel research into detection of early dry eye prior to surgeries, efforts to establish appropriate therapeutics and a greater attempt to regulate and oversee medications, preservatives and procedures should be considered.
Collapse
Affiliation(s)
- José Alvaro P Gomes
- Dept. of Ophthalmology and Visual Sciences, Federal University of Sao Paulo/Paulista School of Medicine (UNIFESP/EPM), São Paulo, SP, Brazil.
| | - Dimitri T Azar
- University of Illinois College of Medicine, Chicago, IL, USA
| | | | - Nathan Efron
- School of Optometry and Vision Science, Queensland University of Technology, Queensland, Australia
| | - Masatoshi Hirayama
- Department of Ophthalmology, School of Medicine, Keio University, Tokyo, Japan
| | | | - Terry Kim
- Duke University School of Medicine, Durham, NC, USA; Duke University Eye Center, Durham, NC, USA
| | | | - Elisabeth M Messmer
- Department of Ophthalmology, Ludwig-Maximilians-University (LMU), Munich, Germany
| | - Jay S Pepose
- Washington University School of Medicine, St. Louis, MO, USA
| | | | | | - Steven E Wilson
- Cole Eye Institute, The Cleveland Clinic, Cleveland, OH, USA
| | | |
Collapse
|
30
|
Abstract
INTRODUCTION Presbyopia is the most prevalent refractive error. With a progressive aging population, its surgical correction is an important challenge for the ophthalmology community, as well as the millions of patients who suffer from it, and who are increasingly demanding alternatives to its correction with glasses or contact lenses. MATERIAL AND METHODS A review is presented with a synthesised discussion on the pathophysiological theories of presbyopia and an updated and analytical description of the non-lens involvement surgical techniques used to treat presbyopia. RESULTS Corneal procedures include various types of corneal implants and photo-ablative techniques that generate a multifocal cornea, or monovision. Scleral procedures exert a traction on supralenticular sclera that supposedly would improve the amplitude of accommodation. CONCLUSIONS None of the techniques are able to completely eliminate the need for near -vision glasses, but many of them manage to improve the refractive status of the patients. More studies with rigorous and standardised methods and longer follow-up are needed to evaluate the changes in the near vision of the patients, in order to corroborate the real and practical usefulness of many of these techniques.
Collapse
Affiliation(s)
- R Bilbao-Calabuig
- Unidad de Cirugía Refractiva y Cataratas, Clínica Baviera Madrid, Madrid, España.
| | - F Llovet-Osuna
- Unidad de Cirugía Refractiva y Cataratas, Clínica Baviera Madrid, Madrid, España
| |
Collapse
|
31
|
Vargas-Fragoso V, Alió JL. Corneal compensation of presbyopia: PresbyLASIK: an updated review. EYE AND VISION 2017; 4:11. [PMID: 28413804 PMCID: PMC5390462 DOI: 10.1186/s40662-017-0075-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2016] [Accepted: 03/28/2017] [Indexed: 11/18/2022]
Abstract
Abstract The main purpose of this review is to compare and analyze the results of the main PresbyLASIK approaches; central and peripheral. Summary A comprehensive research was conducted in PUBMED using keywords like “presbyopia correction”, “PresbyLASIK”, “Corneal multifocality”, “Laser blended vision”. We reviewed the PresbyLASIK technique, uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected near visual acuity (UNVA), and corrected near visual acuity (CNVA), and compared the differences between the techniques.
Collapse
Affiliation(s)
| | - Jorge L Alió
- Vissum Corporation, Edificio Vissum, Calle Cabañal 1, Alicante, Spain.,Division of Ophthalmology, Universidad Miguel Hernández, Carretera Alicante-Valencia km 8.7, Alicante, Spain
| |
Collapse
|
32
|
Whang WJ, Yoo YS, Joo CK, Yoon G. Changes in Keratometric Values and Corneal High Order Aberrations After Hydrogel Inlay Implantation. Am J Ophthalmol 2017; 173:98-105. [PMID: 27697473 DOI: 10.1016/j.ajo.2016.09.027] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Revised: 09/22/2016] [Accepted: 09/23/2016] [Indexed: 11/28/2022]
Abstract
PURPOSE We sought to analyze surgically induced refractive change (SIRC) and change in high-order aberration after Raindrop corneal inlay insertion (ReVision Optics, Lake Forest, CA), and assess the extent to which Raindrop corneal inlay insertion could correct presbyopia. DESIGN Interventional case series. METHODS Seventeen patients were included if they had a corneal thickness ≥500 μm and a stable manifest spherical equivalent refraction between 0.50 and +1.00 diopters (D). The Raindrop corneal inlay was implanted on the stromal bed of a femtosecond laser-assisted generated flap of nondominant eyes. Manifest refraction, corneal powers, and corneal high-order aberrations were measured preoperatively and at 3 and 12 months postoperatively. RESULTS The SIRC by manifest refraction was 0.99 ± 0.26 D. The changes derived from simulated keratometry (K), true net power, and equivalent K reading (EKR) at 1.0-4.0 mm were greater than the SIRC (all P < .01) while the change in EKR at 6.0 mm was less than the SIRC (P < .01). The changes in EKR 5.0 mm, automated K, and EKR 4.5 mm did not differ significantly from the SIRC (P = .81, .29, and .09, respectively), and the difference was the least for EKR 5.0 mm. In analysis of high-order aberrations, only spherical aberration showed statistically significant difference between preoperative and postoperative on both anterior cornea and total cornea (all P < .01). CONCLUSION Raindrop corneal inlay corrects presbyopia via increasing negative spherical aberration. The equivalent K reading at 5.0 mm accurately reflected the SIRC, and would be applicable for intraocular power prediction before cataract surgery.
Collapse
Affiliation(s)
- Woong-Joo Whang
- Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Young-Sik Yoo
- Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Choun-Ki Joo
- Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
| | - Geunyoung Yoon
- Flaum Eye Institute, Center for Visual Science, The Institute of Optics, University of Rochester, Rochester, New York
| |
Collapse
|
33
|
Garcia-Gonzalez M, Teus MA, Gros-Otero J. Re: Whitman et al.: Treatment of presbyopia in emmetropes using a shape-changing corneal inlay: one-year clinical outcomes (Ophthalmology 2016;123:466-75). Ophthalmology 2016; 123:e71. [PMID: 27871403 DOI: 10.1016/j.ophtha.2016.03.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2016] [Accepted: 03/21/2016] [Indexed: 10/20/2022] Open
Affiliation(s)
| | - Miguel A Teus
- Department of Ophthalmology, Clínica Novovision, Madrid, Spain
| | | |
Collapse
|
34
|
Whitman J, Hovanesian J, Steinert RF, Koch D, Potvin R. Through-focus performance with a corneal shape–changing inlay: One-year results. J Cataract Refract Surg 2016; 42:965-71. [DOI: 10.1016/j.jcrs.2016.04.024] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Revised: 04/19/2016] [Accepted: 04/24/2016] [Indexed: 11/28/2022]
|
35
|
|