Changes in Keratometric Values and Corneal High Order Aberrations After Hydrogel Inlay Implantation

Am J Ophthalmol. 2017 Jan:173:98-105. doi: 10.1016/j.ajo.2016.09.027. Epub 2016 Sep 30.

Abstract

Purpose: We sought to analyze surgically induced refractive change (SIRC) and change in high-order aberration after Raindrop corneal inlay insertion (ReVision Optics, Lake Forest, CA), and assess the extent to which Raindrop corneal inlay insertion could correct presbyopia.

Design: Interventional case series.

Methods: Seventeen patients were included if they had a corneal thickness ≥500 μm and a stable manifest spherical equivalent refraction between 0.50 and +1.00 diopters (D). The Raindrop corneal inlay was implanted on the stromal bed of a femtosecond laser-assisted generated flap of nondominant eyes. Manifest refraction, corneal powers, and corneal high-order aberrations were measured preoperatively and at 3 and 12 months postoperatively.

Results: The SIRC by manifest refraction was 0.99 ± 0.26 D. The changes derived from simulated keratometry (K), true net power, and equivalent K reading (EKR) at 1.0-4.0 mm were greater than the SIRC (all P < .01) while the change in EKR at 6.0 mm was less than the SIRC (P < .01). The changes in EKR 5.0 mm, automated K, and EKR 4.5 mm did not differ significantly from the SIRC (P = .81, .29, and .09, respectively), and the difference was the least for EKR 5.0 mm. In analysis of high-order aberrations, only spherical aberration showed statistically significant difference between preoperative and postoperative on both anterior cornea and total cornea (all P < .01).

Conclusion: Raindrop corneal inlay corrects presbyopia via increasing negative spherical aberration. The equivalent K reading at 5.0 mm accurately reflected the SIRC, and would be applicable for intraocular power prediction before cataract surgery.

MeSH terms

  • Cornea / pathology
  • Cornea / surgery*
  • Corneal Topography
  • Corneal Wavefront Aberration / diagnosis*
  • Corneal Wavefront Aberration / etiology
  • Female
  • Follow-Up Studies
  • Humans
  • Hydrogel, Polyethylene Glycol Dimethacrylate*
  • Male
  • Middle Aged
  • Postoperative Complications
  • Presbyopia / physiopathology
  • Presbyopia / surgery*
  • Prostheses and Implants*
  • Refraction, Ocular*
  • Surgical Flaps
  • Visual Acuity*

Substances

  • Hydrogel, Polyethylene Glycol Dimethacrylate