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OCT study shows epithelial remodeling, corneal profile changes after inlay implantation

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MAASTRICHT, Netherlands — An OCT study was able to show in vivo the stromal and epithelial remodeling occurring after implantation of a corneal inlay, giving insights on the functional outcomes of this specific option for presbyopia.

Béatrice Cochener, MD, PhD, is a clinical investigator for the Raindrop near vision inlay (ReVision Optics), a tiny hydrogel implant that creates a hyperprolate shape of the cornea to increase depth of focus and near vision.

Béatrice Cochener

“Using the Optovue Fourier domain OCT, we were able to scan the epithelium and see how it evolved after implantation of the inlay under a femtosecond flap in five presbyopic emmetropes. OCT image processing showed regional thinning of 16 µm in the 2-mm area of the inlay diameter. As a typical response, thickening occurred in the periphery because the epithelium works hard to smoothen the ocular surface. We [have known this for] a long time, but it is nice now to be able to demonstrate it using the OCT,” Cochener said at the European Society of Cataract and Refractive Surgeons winter meeting.

OCT also showed how the inlay volume raises the anterior stroma. The Bowman’s layer moves forward and the cornea takes the shape of the inlay, creating a profocal profile that significantly improves uncorrected near vision. The rise in the anterior stroma lifts the epithelium, which flows outward beyond the inlay diameter. Because of this outward flow, the effect of the inlay extends to potentially twice its diameter, Cochener explained.

“Because of this larger area of refractive effect, this inlay is less sensitive to decentration,” she said. “Absence of ocular surface conditions means that the epithelium thinning is well tolerated. No complications have been reported at 5 years of follow-up.” – by Michela Cimberle

Reference:

Cochener B, et al. Epithelial remodeling induced by a corneal hydrogel, shape changing inlay. European Society of Cataract and Refractive Surgeons winter meeting; Feb. 10-12, 2017; Maastricht, Netherlands.

Disclosure: Cochener reports she is a clinical investigator for ReVision Optics.