Intracorneal inlay to correct presbyopia: Long-term results

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PURPOSE: To evaluate the long-term visual results of Acufocus ACI-7000 (now Kamra) intracorneal inlay implantation in presbyopic phakic patients. SETTING: Beyoğlu Eye Training and Research Hospital, Istanbul, Turkey. DESIGN: Clinical trial. METHODS: This study comprised patients with emmetropic or post-laser in situ keratomileusis (LASIK) presbyopia. Patients had an uncorrected near visual acuity (UNVA) of 20/40 or worse, correctable to 20/25 or better at distance. The inlay was implanted on the stromal bed after the LASIK flap was relifted or a flap created. The inlay was centered on the presurgical position of the first Purkinje reflex. The main outcome measures were distance and near vision and the complication rate. RESULTS: The study enrolled 39 patients aged 45 to 60 years. At the 4-year follow-up, all patients (N = 22) had 2 or more lines of improvement in UNVA with no significant loss in distance vision. The mean final UNVA was 20/20 (Jaeger [J1]); 96% of patients could read J3 or better. The uncorrected distance acuity was 20/40 or better in all eyes. Five patients had cataract progression, and 2 had a change in refractive status. No eye with an intracorneal inlay had intraoperative complications during cataract extraction. Four inlays were explanted during the study. There were no severe corneal complications that affected final vision. CONCLUSION: Intracorneal inlay implantation was an effective, safe, and reversible procedure for the long-term surgical treatment of presbyopia.