Small-aperture corneal inlay in patients with prior radial keratotomy surgeries
A 46-year-old female with a history of RK surgery 20 years prior was a candidate for presbyopia treatment by KAMRA inlay implantation surgery. Since there was a refractive error as a residual outcome from a prior refractive surgery and the patient complained about her distance vision, a LASIK procedure was performed on the same day as, but just prior to, the inlay implantation surgery. The preoperatively measured pachymetry was 567 μm.\nDuring the surgery, a 200 μm corneal flap was created in the nondominant eye using a femtosecond laser (iFS, Advanced Medical Optics, Inc, Santa Ana, CA, USA). The flap had a superior hinge with a 30° side cut and a 4 × 4 spot-line separation. The refractive error was corrected with an excimer laser (Allegretto Wave® Eye-Q, Alcon Incorporated, Hünenberg, Switzerland). The target correction was −0.75 D based on cycloplegic refraction. The LASIK correction and flap replacement were performed in the usual fashion. The inlay was implanted under the flap over the estimated line as described for the patient in Case 1 ().