Structural Changes Induced by a Corneal Shape-Changing Inlay, Deduced From Optical Coherence Tomography and Wavefront Measurements

Lang, Alan; Holliday, Keith; Chayet, Arturo; Barragán-Garza, Enrique; Kathuria, Nikhita

doi:10.1167/iovs.15-18858

Cited by 8 publications

(13 citation statements)

References 19 publications

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“…Unlike traditional laser refractive surgery, inlays do not remove any tissue and therefore can be removed/reversed with little consequence if there have been no complications. The surgical placement of a corneal meniscus shaped inlay beneath a corneal flap alters the stroma anterior to the inlay to adopt predominately the inlay's shape (Lang et al, 2016). The epithelium remodels within a zone approximately twice the inlay diameter (Lang et al, 2016), with ~19 microns of central (~1 mm radius) central thinning regardless of the refractive error treated (Steinert et al, 2017).…”

Section: Inlaysmentioning

confidence: 99%

“…The surgical placement of a corneal meniscus shaped inlay beneath a corneal flap alters the stroma anterior to the inlay to adopt predominately the inlay's shape (Lang et al, 2016). The epithelium remodels within a zone approximately twice the inlay diameter (Lang et al, 2016), with ~19 microns of central (~1 mm radius) central thinning regardless of the refractive error treated (Steinert et al, 2017). One disadvantage of the monocular approach of implanting inlays to increase the depth of focus of the visual system is the resulting anisocoria creates an imbalance in the retinal illuminances between the two eyes.…”

Section: Inlaysmentioning

confidence: 99%

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Presbyopia: Effectiveness of correction strategies

Wolffsohn

Davies

2019

Progress in Retinal and Eye Research

231

178

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Presbyopia is a global problem affecting over a billion people worldwide. The prevalence of unmanaged presbyopia is as high as 50% of those over 50 years of age in developing world populations, due to a lack of awareness and accessibility to affordable treatment, and is even as high as 34% in developed countries. Definitions of presbyopia are inconsistent and varied, so we propose a redefinition that states "presbyopia occurs when the physiologically normal age-related reduction in the eye's focusing range reaches a point, when optimally corrected for distance vision, that the clarity of vision at near is insufficient to satisfy an individual's requirements". Strategies for correcting presbyopia include separate optical devices located in front of the visual system (reading glasses) or a change in the direction of gaze to view through optical zones of different optical powers (bifocal, trifocal or progressive addition spectacle lenses), monovision (with contact lenses, intraocular lenses, laser refractive surgery and corneal collagen shrinkage), simultaneous images (with contact lenses, intraocular lenses and corneal inlays), pinhole depth of focus expansion (with intraocular lenses, corneal inlays and pharmaceuticals), crystalline lens softening (with lasers or pharmaceuticals) or restored dynamics (with 'accommodating' intraocular lenses, scleral expansion techniques and ciliary muscle electrostimulation); these strategies may be applied differently to the two eyes to optimise the range of clear focus for an individual's task requirements and minimise adverse visual effects. However, none fully overcome presbyopia in all patients. While the restoration of natural accommodation or an equivalent remains elusive, guidance is given on presbyopic correction evaluation techniques.

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Section: Inlaysmentioning

confidence: 99%

Section: Inlaysmentioning

confidence: 99%

Presbyopia: Effectiveness of correction strategies

Wolffsohn

Davies

2019

Progress in Retinal and Eye Research

231

178

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“… 6 A prospective study in 30 emmetropic presbyopic patients demonstrated the epithelium remodels within a zone about twice the diameter of the inlay. 12 In that study, the central anterior corneal surface rose by an average of 9.8 µm, providing a progressive add power profile. This change in anterior corneal height provides for better near and intermediate vision.…”

Section: Introductionmentioning

confidence: 76%

Comparison of a hydrogel corneal inlay and monovision laser in situ keratomileusis in presbyopic patients: focus on visual performance and optical quality

Verdoorn

2017

OPTH

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PurposeTo compare the visual performance and optical quality after Raindrop Near Vision Inlay implantation or monovision LASIK for the correction of presbyopia.Materials and methodsIn this retrospective case-series study, patients previously treated in the nondominant eye with monovision LASIK were compared with patients previously implanted with Raindrop Near Vision Inlay. The study enrolled 16 inlay and 15 monovision LASIK patients. Uncorrected near visual acuity, uncorrected distance visual acuity, binocular stereopsis, patient satisfaction, and patient task performance were assessed.ResultsPostoperatively, the mean spherical equivalent was −0.66 D (0.78 SD) for the inlay group and −1.03 D (0.56 SD) for the monovision LASIK group. Monocularly, at uncorrected near distances, 60% of inlay patients and 47% of monovision LASIK patients achieved ≥20/20. Monocularly, at uncorrected far distances, 75% of inlay patients and 40% of monovision LASIK patients achieved ≥20/32 vision. Binocularly, at near distances, 79% of inlay patients and 53% of monovision LASIK patients obtained ≥20/20 vision. All patients achieved ≥20/20 binocularly for distance. On average, inlay patients obtained 98 seconds of arc and monovision LASIK patients obtained 286 seconds of arc for stereopsis. Most (79%) of the inlay patients and 66% of monovision LASIK patients were satisfied with their near vision, while 86% of inlay patients and 67% of monovision LASIK patients were satisfied with their distance vision.ConclusionPatients receiving corneal inlays demonstrated better near and distance visual acuities, binocular stereopsis, task performance, and satisfaction, when compared to patients treated with monovision LASIK.

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“…The FDA-approved Raindrop Near Vision Inlay 5 (ReVision Optics, Inc., Lake Forest, CA) remodels the anterior corneal surface, 6 creating a "profocal" add-power profile 7 at the center of the pupil by means of a meniscus-shaped biocompatible hydrogel "spacer" place in the cornea stroma at approximately 30% of the preoperative central corneal thickness. In the stroma, the meniscus-shaped inlay has no optical power because the inlay's index of refraction is the same as the stroma.…”

Section: Resultsmentioning

confidence: 99%

“…Total-eye wavefront measurements were used to establish the position of the corneal inlay with respect to the light-constricted pupil and CSCLR. In prior publications, wavefront measurements were used to calculate the change to the anterior corneal surface induced by the corneal inlay's volume, 6 establishing the contributions from epithelial and stromal remodeling. In another publication, the induced add-power changes from wavefront measurements combined with theoretical optical simulations were used to establish the inlay's mechanism of action and explain the range of depth of focus.…”

mentioning

confidence: 99%