Vissum Corporacion, Alicante, Spain.
J Refract Surg. 2013 Aug;29(8):550-6. doi: 10.3928/1081597X-20130719-05.
To evaluate the safety of the corneal inlay removal procedure and the reversibility of visual acuities, corneal topography, and corneal biomicroscopy changes in a series of cases.
Ten cases implanted with one of three versions of the AcuFocus Kamra Inlay (ACI 7000, 7000T, and 7000PDT; AcuFocus, Inc., Irvine, CA) were followed for a minimum of 6 months after corneal inlay removal.
The reason for removal was related to subjective dissatisfaction with visual symptoms (8 of 10 patients) such as night glare, photophobia, starburst, blurry vision, and halos. One case of removal was related to inadvertent thin flap and the final case was related to insufficient near vision. Mean uncorrected distance visual acuity (UDVA) and uncorrected near visual acuity (UNVA) was 0 ± 0.1 logMAR (Snellen 20/20) and 0.5 ± 0.2 logMAR (Snellen 20/40), respectively, preoperatively and 0.1 ± 0.1 logMAR (Snellen 20/25) and 0.5 ± 0.1 logMAR (Snellen 20/63), respectively, 6 months after corneal inlay removal. Mean corrected distance visual acuity (CDVA) and corrected near visual acuity (CNVA) was 0 ± 0.1 logMAR (Snellen 20/20) and 0 ± 0.1 logMAR (Snellen 20/20), respectively, preoperatively and 0 ± 0.1 logMAR (Snellen 20/20) and 0.1 ± 0.1 logMAR (Snellen 20/25), respectively, 6 months after corneal inlay removal. Mean root mean square (RMS) higher-order aberration (HOA) was 0.50 ± 0.12 (range: 0.30 to 0.70) preoperatively and 0.69 ± 0.14 (range: 0.48 to 0.95) 6 months after corneal inlay removal (P < .8). Weak positive correlation was found between Δt Implant-Removal (Δt I-R), RMS spherical, coma, and HOA at 6 months (Δt I-R vs RMS spherical was r = 0.2, r(2) = 0.5, P < .7; Δt I-R vs RMS coma was r = 0.8, r(2) = 0.6, P < .3; and Δt I-R vs HOA r = 0.8; r(2) = 0.6, P < .9).
This study suggests that after removal of the corneal inlay, corneal topography and corneal aberrometry are not permanently affected. In more than 60% of patients, CNVA, CDVA, UNVA, and UDVA were similar to the preoperative value.
评估一系列病例中角膜镶嵌物去除手术的安全性和视力、角膜地形、角膜生物显微镜变化的可逆性。
10 例植入三种 AcuFocus Kamra Inlay（ACI 7000、7000T 和 7000PDT；AcuFocus，Inc.，加利福尼亚州欧文）的患者，在角膜镶嵌物去除后至少随访 6 个月。
去除的原因与主观视觉症状不满意有关（10 例中的 8 例），如夜间眩光、畏光、星爆、视力模糊和光环。1 例与无意中的薄瓣有关，最后 1 例与近距离视力不足有关。术前平均未矫正远视力（UDVA）和未矫正近视力（UNVA）分别为 0±0.1 对数视力（20/20 视力表）和 0.5±0.2 对数视力（20/40 视力表），术后 6 个月分别为 0.1±0.1 对数视力（20/25 视力表）和 0.5±0.1 对数视力（20/63 视力表）。术前平均矫正远视力（CDVA）和矫正近视力（CNVA）分别为 0±0.1 对数视力（20/20 视力表）和 0±0.1 对数视力（20/20 视力表），术后 6 个月分别为 0±0.1 对数视力（20/20 视力表）和 0.1±0.1 对数视力（20/25 视力表）。术前平均均方根（RMS）高阶像差（HOA）为 0.50±0.12（范围：0.30 至 0.70），术后 6 个月为 0.69±0.14（范围：0.48 至 0.95）（P<.8）。角膜镶嵌物去除后 6 个月，Δt 植入物-去除（Δt I-R）与 RMS 球镜、彗差和 HOA 之间存在弱正相关（Δt I-R 与 RMS 球镜的 r=0.2，r(2)=0.5，P<.7；Δt I-R 与 RMS 彗差的 r=0.8，r(2)=0.6，P<.3；Δt I-R 与 HOA 的 r=0.8；r(2)=0.6，P<.9）。
本研究表明，角膜镶嵌物去除后，角膜地形和角膜像差不会永久受到影响。在超过 60%的患者中，CNVA、CDVA、UNVA 和 UDVA 与术前值相似。
