Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft · 2017
[The KAMRA™ inlay : A realistic approach?].
Клиническое исследованиеСтатьяНазвание и аннотация: Перевод пока не подготовлен
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El-Husseiny M, Daas L, Viestenz A, Langenbucher A, Seitz B
Аннотация
BACKGROUND AND PURPOSE: The KAMRA™ inlay (AcuFocus, Irvine, California, USA) is an additional option for correcting presbyopia that has been used for many years in refractive surgery. Our objective is to report our three-month postoperative results of KAMRA™ inlay implantation in terms of near, intermediate and distance vision.
PATIENTS AND METHODS: All 24 patients (average age 54.1 ± 6.0 years) were treated with the KAMRA™ inlay in the non-dominant eye (75 % in the left eye) by the same surgeon (MEH). The KAMRA™ inlay was implanted under a 200 µm-thick femtosecond laser-assisted LASIK flap in 2 emmetropic presbyopic patients, 13 hyperopic presbyopic patients and 9 myopic presbyopic patients, without ocular pathologies. The uncorrected distance, intermediate, and near vision were assessed. The central corneal thickness (CCT), endothelial cell density (ECD) and visual field were assessed both pre- and post-operatively. In addition, patients were asked to complete a patient satisfaction questionnaire. Follow-ups were carried out one day, one week, and 1, 3, 6, 9 and 12 months postoperatively.
RESULTS: After three months, all 24 eyes revealed an increase in the mean uncorrected distant visual acuity in the non-dominant eye from 0.4 ± 0.2 to 0.9 ± 0.1, an increase in the mean uncorrected intermediate visual acuity (logMAR, Jaeger 75 cm) from 0.6 ± 0.3 (J 11) to 0.0 ± 0.0 (J 1) and an increase in the mean uncorrected near visual acuity (logMAR, Jaeger 45 cm) from 0.6 ± 0.2 (J 9) to 0.0 ± 0.0 (J 1) monocularly. The visual acuity did not change over the time. The CCT and ECD remained unchanged compared with the findings before surgery. Subjectively, the questionnaire showed high patient satisfaction.
CONCLUSION: Femtosecond laser-assisted KAMRA™ inlay implantation can be used in post-LASIK emmetropic patients and patients with a monofocal intraocular lens. It can also be combined with LASIK (for ametropic patients). The potential reversibility, low impairment of psychophysical investigations and the high degree of patient satisfaction makes this novel technique designed to increase depth of focus a reliable method for the surgical correction of presbyopia. Patient selection and centration of the KAMRA™ inlay is crucial.
PATIENTS AND METHODS: All 24 patients (average age 54.1 ± 6.0 years) were treated with the KAMRA™ inlay in the non-dominant eye (75 % in the left eye) by the same surgeon (MEH). The KAMRA™ inlay was implanted under a 200 µm-thick femtosecond laser-assisted LASIK flap in 2 emmetropic presbyopic patients, 13 hyperopic presbyopic patients and 9 myopic presbyopic patients, without ocular pathologies. The uncorrected distance, intermediate, and near vision were assessed. The central corneal thickness (CCT), endothelial cell density (ECD) and visual field were assessed both pre- and post-operatively. In addition, patients were asked to complete a patient satisfaction questionnaire. Follow-ups were carried out one day, one week, and 1, 3, 6, 9 and 12 months postoperatively.
RESULTS: After three months, all 24 eyes revealed an increase in the mean uncorrected distant visual acuity in the non-dominant eye from 0.4 ± 0.2 to 0.9 ± 0.1, an increase in the mean uncorrected intermediate visual acuity (logMAR, Jaeger 75 cm) from 0.6 ± 0.3 (J 11) to 0.0 ± 0.0 (J 1) and an increase in the mean uncorrected near visual acuity (logMAR, Jaeger 45 cm) from 0.6 ± 0.2 (J 9) to 0.0 ± 0.0 (J 1) monocularly. The visual acuity did not change over the time. The CCT and ECD remained unchanged compared with the findings before surgery. Subjectively, the questionnaire showed high patient satisfaction.
CONCLUSION: Femtosecond laser-assisted KAMRA™ inlay implantation can be used in post-LASIK emmetropic patients and patients with a monofocal intraocular lens. It can also be combined with LASIK (for ametropic patients). The potential reversibility, low impairment of psychophysical investigations and the high degree of patient satisfaction makes this novel technique designed to increase depth of focus a reliable method for the surgical correction of presbyopia. Patient selection and centration of the KAMRA™ inlay is crucial.