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    Device improves irregular astigmatism in pseudophakic eyes

    Sulcus-supported implant applies well-known principle of pinhole aperture

    Take-home message: A pinhole implant placed in the ciliary sulcus can improve visual acuity and reduce dysphotic symptoms in pseudophakic eyes with irregular corneal astigmatism. Implantation is even easier with the latest version of the investigational device


    Belo Horizonte, Brazil—Ciliary sulcus implantation of a pinhole intraocular implant is showing promise as a safe and effective method for treating irregular corneal astigmatism in pseudophakic eyes, according to Claudio C. Trindade, MD, its inventor.

    The device is currently investigational and is being developed by Morcher. As of April 2015, Dr. Trindade had implanted the device, which is now in its third iteration, into 17 eyes that had a mean follow-up of 14 months.

    Irregular astigmatism in these cases was associated with previous penetrating keratoplasty in 6 eyes, prior radial keratotomy in 5 eyes, and keratoconus in 6 eyes. All eyes benefited with improvement in visual acuity and reduction of dysphotopic symptoms.

    So far, the device has remained well-centered with good clearance from the primary IOL, and there have not been any complications, noted Dr. Trindade, private practice, Cancado-Trindade Eye Institute, Belo Horizonte, Brazil, and a PhD Program member, University of Sao Paulo, Brazil

    “A pinhole aperture minimizes the negative impact of corneal optical aberrations on image resolution by excluding peripheral ocular light rays, and it is well-known for its benefit of improving vision in eyes with irregular corneal astigmatism. The idea of implanting a pinhole device in the ciliary sulcus is based on the idea that the more physiological place for a small aperture device is close to the pupillary plane and takes into account the long track record of safety of piggyback IOLs,” he said.

    “Results from bench testing of this device at an optical engineering laboratory showed it caused a remarkable reduction of total aberrations, and clinical experience with it so far has been positive. Now longer follow-up in more eyes is needed.”

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