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Simultaneous LASIK, corneal inlay implantation improve near, distance vision
ORLANDO, Fla. — Simultaneous treatment of presbyopia and refractive error with LASIK and corneal inlay implantation improved vision, particularly in older patients, according to a large study presented here.
"At 6 months, close to 90% of patients reported being satisfied or highly satisfied with their outcomes," Minoru Tomita, MD, PhD, said at the American Academy of Ophthalmology meeting. "After 6 months, about 95% of patients reported decreased dependence on their glasses."
The study included 2,000 patients who underwent simultaneous LASIK and implantation of the Kamra intracorneal inlay (AcuFocus) between 2009 and 2011. The inlay was implanted in only the non-dominant eye.
Patients were classified into age group by decade: 40s, 50s and 60s.
Study results at 6 months postop showed that mean uncorrected near visual acuity at 30 cm was J2 in the 40s and 50s age group and J3 in the 60s age group.
Patients in their 40s gained three lines of vision, those in their 50s gained four lines, and those in their 60s gained five lines, Dr. Tomita said.
Mean uncorrected distance visual acuity was 20/20 or better in all age groups, he said.
Concurrent centration of the LASIK flap, ablation zone and inlay implantation site was not particularly problematic, Dr. Tomita said in response to a question from an audience member.
- Disclosure: Disclosure: Dr. Tomita has financial relationships with AcuFocus, Schwind and Zimmer.
With new technology and design changes, the Kamra lens is coming to fruition. In fact, four of my ophthalmic friends have had this treatment with success. The take-home message is the combination of laser vision correction and placement of the lens can provide near vision and intermediate vision benefits. Dr. Tomita and his fellow surgeons are to be commended for a study of multiple high-volume surgeons that shows that through the ages of 40 to 60 years all patients show benefit. Although early years showed more range of function, the overall acceptance of the combined procedures was high.
Application of this technology ultimately depends on its FDA approval. Dr. Tomita noted in his lecture that the patients are being followed longitudinally and adverse events will be followed. Hopefully, if the positive trends continue as was reported in this series of patients, U.S. doctors will ultimately have another option other than a lens-based procedure for our patients.
– Karl G. Stonecipher, MD
Clinical
Assistant Professor of Ophthalmology, UNC
Medical Director TLC, Greensboro
and Raleigh
Medical Director Amsurg, Greensboro, N.C.
Disclosure: Dr.
Stonecipher has no relevant financial disclosures.