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Speaker credits optical principle for long-term success of intracorneal inlay in plano presbyopes
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The dramatic improvements that clinicians have seen in near vision and stabilized distance vision in plano presbyopes implanted with an intracorneal inlay can be attributed to the distinctive depth of focus principle that governs the implant's optics, a speaker said.
"Small aperture inlays like an AcuFocus inlay change the corneal optics," Daniel S. Durrie, MD, said at Hawaiian Eye 2011. "It's an unusual optical principal."
Dr. Durrie, OSN Refractive Surgery Section Editor, presented clinical results from two cohorts of plano presbyopes who have been implanted with two different versions of the AcuFocus intracorneal inlay.
At 36 months, in a cohort of 44 patients implanted with the first version of the implant, which was 10-µm thick and offered 11% light transmission, corrected distance visual acuity averaged 20/25, uncorrected distance visual acuity averaged 20/25 and uncorrected near vision averaged J2.
At 30 months, a second cohort of 119 plano presbyopes implanted with a newer version of the implant with 7% light transmission achieved average corrected distance vision of 20/16, average uncorrected distance vision of 20/20 and an uncorrected near acuity of J1, Dr. Durrie said.
"Over 3 years, presbyopia didn't get worse. These patients saw just as well at near at 3 years. Any of you who are presbyopic — you're not wearing the same reading glasses you did 3 years ago," Dr. Durrie said.
Dr. Durrie said that the first version of the inlay allowed too much light to pass through the lens, which contributed to patients seeing halos. However, the current commercially available version, which is 5-µm thick and offers 5% light transmission, has improved results.
"The reason ... is this depth-of-focus principle," Dr. Durrie said. "As the patient gets more presbyopic, [the inlay] compensates for it because it can compensate with a depth of focus."
- Disclosure: Dr. Durrie is a paid consultant for AcuFocus.
This study shows that there are multiple relatively effective options for the treatment of presbyopia, but there is still no true cure. The newer version of the AcuFocus inlay appeared to provide better vision as a result of decreased transmission of light through the inlay. It is an example of how we can re-balance the optics of the eye in order to provide a wider range of vision without spectacles, and it is further proof that refractive surgeons must offer a full spectrum of corneal and lenticular surgery in order to provide the most options for patients.
– Uday Devgan, MD
OSN SuperSite Section
Editor
Disclosure: Dr. Devgan has no financial interests in the company or
product mentioned.
Hawaiian Eye and Retina 2012 will be held January 15-20 at the Grand Wailea Resort & Spa in Maui. Learn more at OSNHawaiianEye.com or RetinaMeeting.com.