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    New corneal inlay offers choice for presbyopia improvement


    Like other corneal inlays, the device can be removed quickly and easily if the patient is dissatisfied with the result or if there are adverse events. The FDA approval notes a number of potential side effects including foreign body sensation and pain, infection, inflammation, new dry eye or exacerbation of existing dry eye, retinal detachment and corneal scarring, swelling, inflammation, thinning, clouding, or melting.

    Related: Virtual eye health and vision examination: Why not?

    Reports of serious adverse events have been few and far between in both investigational and clinical settings, Dr. Chu said. Inlay is completely invisible after implantation. Courtesy of ReVision Optics

    “At this point, the [inlay] has only been available to clinical investigators in the United States,” Dr. Chu said. “Clinical experience outside the United States has been generally very positive.”

    In his own cohort, the average near visual acuity increased from 20/63 before implantation to 20/20 eighteen months postop. Intermediate visual acuity improved from 20/40 to 20/25. Monocular distance vision in the treated eye decreased slightly from 20/20 to 20/25, but binocular distance vision improved slightly from 20/20 to 20/16.

    More: Treating presbyopia with an eye drop?

    The mean MRSE shifted to about -1.0 at six months, then stabilized about -0.75 by 18 months. There was minimal induced astigmatism and the refractive cylinder remains stable after surgery. The incidence of glare and halo was about 4%. The smooth, gradual shift in corneal topography minimizes the risk of optical side effects, Dr. Chu noted.

    “The potential downside to this inlay as well as other inlays is that the technology is placed into one eye,” he continued. “Patients have to be able to tolerate and function with a one-eye procedure. The incidence of glare and halo is not 0% from any procedure, something patients need to know about. From the surgical perspective, you have to look for a healthy ocular surface. Patients need to have minimal symptoms of dry eye or have dryness appropriately managed in order to have a good visual outcome.”

    Other inlays

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