Comparison of Intracorneal Inlay for Presbyopia Correction: Hydrogel and Small-Aperture Inlays with a Six- Months Follow-Up

ABSTRACT

PURPOSE: To study the safety and efficacy of corneal reshaping and small-aperture inlays and compare the clinical results. METHODS: From February 2014 to November 2014, 22 corneal reshaping inlays were inserted at Asan Medical Center and from October 2012 to March 2013, 26 small-aperture inlay surgeries were performed: 6 eyes at Asan Medical Center and 20 eyes at Samsung Medical Center. The preoperative and postoperative parameters were reviewed retrospectively and included monocular uncorrected distance visual acuity (UDVA; log MAR), uncorrected near visual acuity (UNVA; log MAR), refraction and corneal curvature based on automated refractor keratometry, reading distance and patient satisfaction. RESULTS: In the hydrogel inlay group, preoperative mean monocular UNVA was 0.83 +/- 0.05 and monocular UDVA 0.07 +/- 0.03. At 6 months, mean monocular UNVA was 0.23 +/- 0.05 and UDVA 0.05 +/- 0.02. The most preferred mean reading distance in the hydrogel inlay group was 39.38 +/- 3.18 cm. In the small-aperture inlay group, preoperative mean monocular UNVA was 0.4 +/- 0.06 and monocular uncorrected visual acuity 0.27 +/- 0.04. At 6 months, mean monocular UNVA was 0.11 +/- 0.02 and UDVA 0.09 +/- 0.05 and the most preferred mean reading distance was 44.23 +/- 5.17 cm. Although 85% of patients in the corneal reshaping inlay group were satisfied or very satisfied, only 20% of patients in the small-aperture inlay group were satisfied. CONCLUSIONS: Both inlays are considered good options for correcting presbyopia. However, postoperative satisfaction score was higher and less glare symptoms were reported in the hydrogel inlay group.