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. 2016 Nov 11:10:2265-2270.
doi: 10.2147/OPTH.S118590. eCollection 2016.

Short-term visual result after simultaneous photorefractive keratectomy and small-aperture cornea inlay implantation

Majid Moshirfar  1 , Ryan T Wallace  2 , David F Skanchy  3 , Jordan D Desautels  4 , Steven H Linn  5 , Phillip C Hoopes Jr  5 , Daniel S Durrie  6
Affiliations

Short-term visual result after simultaneous photorefractive keratectomy and small-aperture cornea inlay implantation

Majid Moshirfar et al. Clin Ophthalmol. .

Abstract

Purpose: To report the short-term results of simultaneous photorefractive keratectomy (PRK) and small-aperture cornea inlay implantation (KAMRA) surgery in treating presbyopia.

Methods: Simultaneous PRK and KAMRA inlay surgery was performed on 21 patients from July 2015 to March 2016. Follow-up exams were conducted at 1, 3, and 6 months postoperatively. Our patients were also divided preoperatively into three categories: myopic, hyperopic, and emmetropic. Over the 6-month period, the main outcome measures were uncorrected near visual acuity (UNVA), changes in best-corrected distance visual acuity, and mean spherical equivalent refraction.

Results: At 6-month follow-up, 83% (10/12) of patients had a monocular UNVA of 20/40 or better, and 75% had a binocular UNVA of 20/40 (J5) or better. At 6 months, the overall mean refractive spherical equivalent (MRSE) was -0.60 D (±0.42 standard deviation [SD], range: -1.38 to -0.13) with a mean change of -0.43 D (±1.19 SD, range: -1.5 to 2.63) compared to preoperative data. Overall, 91% (10/11) of patients were within a ±0.5 D range of our target -0.75 D for KAMRA use. One-hundred percent (5/5) of the hyperopes, 50% (1/2) of emmetropes, and 100% (4/4) of myopes met the targeted range. At 6 months, the MRSE for the hyperopic subgroup (n=5) was 0.33 D (±0.20 SD), the MRSE for the emmetropic subgroup (n=2) was -1.19 D (±0.19 SD), and the MRSE for the myopic subgroup (n=4) was -0.66 D (±0.36 SD).

Conclusion: Based on preliminary results and a small sample size, it seems that simultaneous PRK and KAMRA is effective and predictable. There are multiple advantages in performing simultaneous PRK and KAMRA including a shorter recovery time and less steroid use than the two surgeries performed separately.

Keywords: KAMRA; PRK; PRKamra; corneal; femptosecond; presbyopia.

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Figures

Figure 1
Figure 1
Cumulative monocular UNVA shown before KAMRA inlay implantation and at 1, 3, and 6 months postoperatively. Abbreviation: UNVA, uncorrected near visual acuity.
Figure 2
Figure 2
Cumulative binocular UNVA shown before KAMRA inlay implantation and at 1, 3, and 6 months postoperatively. Abbreviation: UNVA, uncorrected near visual acuity.
Figure 3
Figure 3
Cumulative preoperative MRSE and changes at 1, 3, and 6 months postoperatively. Abbreviation: MRSE, mean refractive spherical equivalent.
See this image and copyright information in PMC

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