Small-aperture corneal inlay in presbyopic patients with prior phakic intraocular lens implantation surgery: 3-month results
A 55-year-old woman had presbyopia correction with inlay implantation in her left eye. Her preoperative visual acuity was evaluated using a Snellen chart for distance and Log-MAR for near vision (which was converted to a Jaeger chart thereafter). Preoperative spherical equivalent (SE) was −0.25 diopter (D); uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA) were 20/20 and 20/16, respectively; and uncorrected near visual acuity (UNVA) and corrected near visual acuity (CNVA) were J4 and J1, respectively. Corneal thickness was 603 μm. The patient underwent a comprehensive preoperative examination. During surgery, the corneal pocket creation was done for the KAMRA inlay implantation with a Crystal Line Femto LDV (Ziemer Ophthalmic Systems AG, Port, Switzerland). The KAMRA inlay implantation was done with a 230 μm pocket depth, not 200 μm as is usual, due to the presence of 603 μm central corneal thickness. The inlay was carefully placed in the pocket over the estimated line of sight based on the midpoint of the first Purkinje image and the pupil center with coaxial patient fixation. Three-month results showed an improvement in UNVA to J2, with even better outcomes for UDVA, which improved to 20/16 (). SE was −1.0 D. CDVA and CNVA remained stable during the follow-up period. The patient did not report needing reading glasses in any light conditions.