Long-term Clinical Outcome of Refractive Corneal Inlays for Compensation of Presbyopia

Abstract

Purpose: To study the long-term efficacy and safety of Flexivue Microlens refractive corneal inlays in Koreans for compensation of presbyopia.Methods: Flexivue Microlens inlays were implanted in nine eyes at Samsung Medical Center from October 2015 to February 2018. The follow-up period was 1.95 ± 0.6 years. Pre- and postoperative near/intermediate/distant visual acuity, spherical equivalent, contrast sensitivity, defocus curve, keratometry, and patient satisfaction were evaluated retrospectively.Results: The uncorrected near visual acuity (UNVA) of the operated eye increased significantly to 0.27 ± 0.10 logarithm of the minimal angle resolution (logMAR) after 6 months (p = 0.012). At the last observation, it was 0.32 ± 0.21 logMAR, which improved compared to before surgery, but the difference was not significant (p = 0.127). The binocular UNVA improved significantly to 0.19 ± 0.78 logMAR at 6 months postoperatively (p = 0.017) and to 0.21 ± 0.13 logMAR at the last observation (p = 0.028). There was no difference in the binocular uncorrected distant visual acuity (UDVA) before and after surgery, but the UDVA of the operated eye decreased significantly to 0.38 ± 0.15 logMAR at 6 months postoperatively (p = 0.007) and to 0.32 ± 0.21 logMAR at the last observation (p = 0.012). Satisfaction with near vision improved significantly after surgery; 14.3% of the patients had a score of 4 (good) or higher and 42.9% did not require near-vision glasses. In one case, the inlay was removed after 17 months due to blurred vision.Conclusions: The Flexivue Microlens has a low risk of complications and is a reversible technique. However, the near vision improvement was temporary and distance vision deteriorated. In addition, the Koreans examined had relatively low satisfaction and high spectacle dependence.