Small‐aperture corneal inlay implantation to treat presbyopia after laser in situ keratomileusis

Purpose To evaluate the visual outcomes after implantation of a Kamra small‐aperture corneal inlay into a femtosecond‐created corneal pocket to treat presbyopia in patients who had previous laser in situ keratomileusis (LASIK). Setting Private center, Tokyo, Japan. Design Prospective interventional case series. Methods Post‐LASIK presbyopic patients had inlay implantation into a corneal pocket created by a femtosecond laser at a depth of 200 &mgr;m or 250 &mgr;m a minimum of 80 &mgr;m below the previous LASIK flap interface in the nondominant eye. Uncorrected and corrected distance visual acuities, near visual acuity, and a patient questionnaire on satisfaction, the use of reading glasses, and visual symptoms were evaluated. Results The study enrolled 223 eyes (223 patients) with a mean age of 53.6 years (range 44 to 65 years) and a mean manifest spherical equivalent of −0.18 diopter (D) (range −1.00 to +0.50 D). The mean uncorrected distance visual acuity in the operated eye decreased 1 line from 20/16 preoperatively to 20/20 6 months postoperatively (P<.001). The mean uncorrected near visual acuity improved 4 lines from Jaeger (J) 8 to J2 (P<.001). At 6 months, significant improvements were observed in patient dependence on reading glasses and patient satisfaction with vision without reading glasses. Conclusion The 6‐month results suggest that implantation of a small‐aperture inlay in post‐LASIK presbyopic patients improves near vision with a minimal effect on distance vision, resulting in high patient satisfaction and less dependence on reading glasses. Financial Disclosure Drs. Tomita and Waring are consultants to Acufocus, Inc. Dr. Tomita is a consultant to Ziemer Group AG. No other author has a financial or proprietary interest in any material or method mentioned.