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Identifier

000377736

Title

Μελέτη της ασφάλειας και αποτελεσματικότητας ενδοκερατοειδικών διαθλαστικών ενθεμάτων για την διόρθωση της πρεσβυωπίας

Alternative Title

Safety and efficacy of intracorneal refractive inlays of presbyopia

Author

Μπουζούκης, Δημήτριος Η

Thesis advisor

Παλλήκαρης, Ιωάννης

Reviewer

Τσιλιμπάρης, Μιλτιάδης
Σιγανός, Χαράλαμπος
Βελεγράκης, Γεώργιος
Ζώρας, Οδυσσέας
Χατζηδάκης, Αδάμ
Κυμιωνής, Γεώργιος

Abstract

Purpose: To investigate the visual outcomes and safety of intracorneal refractive inlays for the surgical treatment of presbyopia and to optimize the intracorneal pocket creation, using femtosecond laser technology. Setting: University Hospital of Crete/Institute of Vision and Optics, Greece. Design: Prospective non comparative interventional clinical study. Participants: Forty-five emmetropic presbiopian patients with a mean age of 52.3 years old ± 3.3 (range: from 47 to 58) were enrolled. Methods: An intrastromal corneal pocket was created using a mechanical microkeratome. The refractive inlay was inserted within the corneal tunnel in 25-300 microns depth inside the non-dominant eye. Follow-up was one year in all patients and visits were scheduled at one week, one, three, six and twelve months after surgery. Mean Outcome Measurements: Near and distant visual acuity, refraction, contrast sensitivity, wavefront analysis, confocal analysis. Results: Mean uncorrected visual acuity for near (UNVA) in the operated eye improved from 20/50 to 20/32 after one week and 20/25 after one month and remained stable during the 12 follow-up months. The mean add power needed for near vision, was decreased in the operated eye from 1.87 ± 0.29 diopters (D) (range: from 1.25 to 2.25 D) to 0.48 ± 0.19 D (range: from plano to 0.75 D). Mean uncorrected visual acuity for distance (UDVA) was 20/32 in the operated eye and 20/20 binocularly twelve months postoperatively from 20/20 in the operated eye and binocularly preoperatively. Three patients lost one line of best spectacle corrected visual acuity for distance (CDVA) and no patient lost two or more lines. None of these patients wished to remove the inlay as they were completely satisfied with their binocular far and near vision. All patients returned to the preoperative refraction with no loss of CDVA for near or distance. No tissue alterations of the cornea were found using corneal confocal microscopy. No intra or late-operative complications were demonstrated up to twelve months after surgery. The creation of the intracorneal pocket has been achieved with the femtosecond laser, using a customize PVC mask to limit the tissue separation only to the desired area. The inlay was successfully, uneventfully and safely implanted into the cornea.. Conclusions: Intracorneal refractive inlays seem to provide a safe, effective and reversible surgical treatment for presbyopia. . The use of femtosecond laser for the creation of the intrastromal pocket, seems to improve the procedure, by optimizing and customizing the pocket formation and simplifying the implantation of the inlay.

Language

Greek

Subject

Cornea

Femtosecond laser

Inlays

Microkeratome

Ophthalmologic Surgical Procedures

Presbyopia therapy

Refractive Surgical Procedures

Ενθέματα

Κερατοειδής