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

• Published in: American journal of ophthalmology 2017-01, Vol.173, p.98-105
• Main Authors: Whang, Woong-Joo, MD, Yoo, Young-Sik, MD, Joo, Choun-Ki, MD, PhD, Yoon, Geunyoung, PhD
• Format: Article
• Language: English
• Subjects: Cornea; Cornea - pathology; Cornea - surgery; Corneal Topography; Corneal Wavefront Aberration - diagnosis; Corneal Wavefront Aberration - etiology; Diabetic retinopathy; Female; Follow-Up Studies; Humans; Hydrogel, Polyethylene Glycol Dimethacrylate; Hydrogels; Male; Middle Aged; Ophthalmology; Optics; Patient satisfaction; Postoperative Complications; Presbyopia - physiopathology; Presbyopia - surgery; Prostheses and Implants; Reading; Refraction, Ocular; Surgery; Surgical Flaps; Topography; Visual Acuity
• ISSN: 0002-9394; 1879-1891
• DOI: 10.1016/j.ajo.2016.09.027

Abstract Purpose To analyze surgically induced refractive change (SIRC) and change in high-order aberration after Raindrop corneal inlay insertion, and assess the extent to which Raindrop corneal inlay insertion could correct presbyopia. Design Interventional case series. Methods 17 patients were included if they had a corneal thickness of 500 μm or greater and a stable manifest spherical equivalent refraction between -0.50 and +1.00 diopters.(D) The Raindrop corneal inlay (ReVision Optics, Lake Forest, CA) was implanted on the stromal bed of a femtosecond laser-assisted generated flap of non-dominant eyes. Manifest refraction, corneal powers, and corneal high-order aberrations were measured preoperatively, 3 months and 12 months postoperatively. Results The SIRC by manifest refraction was 0.99 ± 0.26 D. The changes derived from simulated K, true net power, and equivalent K-reading (EKR) at 1.0–4.0 mm were greater than the SIRC (all p < 0.01) while the change in EKR at 6.0 mm was less than the SIRC ( p < 0.01). The changes in EKR 5.0 mm, automated keratometry, and EKR 4.5 mm did not differ significantly from the SIRC ( p = 0.81, 0.29, and 0.09 respectively), and the difference was the least for EKR 5.0 mm. In analysis of HOAs, only spherical aberration showed statistically significant difference between preoperative and postoperative on both anterior cornea and total cornea, (all p < 0.01) 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.