Moshirfar Majid, Lau Chap-Kay, Chartrand Nicholas A, Parsons Mark T, Stapley Seth, Bundogji Nour, Ronquillo Yasmyne C, Linn Steven H, Hoopes Phillip C
Hoopes Vision Research Center, Hoopes Vision, Draper, UT, USA.
John A. Moran Eye Center, University of Utah School of Medicine, Salt Lake City, UT, USA.
Clin Ophthalmol. 2022 Oct 10;16:3327-3337. doi: 10.2147/OPTH.S382544. eCollection 2022.
To evaluate 10 years of KAMRA corneal inlay explantation and associated visual outcomes.
Single-site retrospective chart review of 22 cases of AcuFocus KAMRA Inlay (ACI7000PDT) explantation (range 1 week-1 year). Uncorrected distance visual acuity (UDVA), uncorrected near visual acuity (UNVA), corrected distance visual acuity (CDVA), and manifest refraction at 1 day, 1 week, 1 month, 3 months, 6 months, and 1 year post-explantation were reviewed.
The explantation rate was 8.2% across 10 years. All patients underwent KAMRA explantation due to dissatisfaction with their vision including blurry near vision, impaired night vision, decreased vision in dim lighting, streaks or halos, haze, and double vision. Mean UDVA pre-implant was -0.01±0.13 logMAR (logarithm of the minimal angle of resolution), 0.30±0.22 logMAR pre-explant, and 0.16±0.15 logMAR post-explant (n=20). Mean UNVA pre-implant was 0.37±0.09 logMAR, 0.38±0.13 logMAR pre-explant, and 0.42±0.21 logMAR post-explant (n=20). Mean CDVA pre-implant was -0.01±0.04 logMAR and 0.05±0.11 logMAR post-explant (n=17). Mean CDVA pre-explant was 0.04±0.07 logMAR and 0.04±0.11 logMAR post-explant (n=19). Significant differences were observed between pre-implant and post-explant UDVA (p=0.009), and between pre-explant and post-explant UDVA (p=0.02). All patients (100%) had 20/20 or better CDVA pre-implant but decreased to 73.7% post-explant. Sixty percent (12/20) of the patients lost UDVA Snellen acuity lines post-explant. MRSE was -0.31±0.29 D pre-implant and +0.26±0.77 D post-explant (p=0.007) with note of a hyperopic shift. The hyperopic shift in 31.6% (6/19) of patients did not resolve after explantation. Post-explant residual corneal haze occurred in 72.7% (16/22) of patients.
Although the KAMRA corneal inlay is a removable device, patients may experience residual corneal haze, hyperopic shift, and deficits in UDVA after explantation compared to pre-implantation UDVA.
评估10年来KAMRA角膜嵌体取出情况及相关视觉效果。
对22例AcuFocus KAMRA角膜嵌体（ACI7000PDT）取出病例（时间范围为1周 - 1年）进行单中心回顾性病历分析。回顾了取出术后1天、1周、1个月、3个月、6个月及1年时的未矫正远视力（UDVA）、未矫正近视力（UNVA）、矫正远视力（CDVA）及明显验光结果。
10年间取出率为8.2%。所有患者因对视力不满意而进行KAMRA角膜嵌体取出，包括近视力模糊、夜间视力受损、暗光下视力下降、条纹或光晕、 haze和复视。植入前平均UDVA为 -0.01±0.13 logMAR（最小分辨角对数），取出前为0.30±0.22 logMAR，取出后为0.16±0.15 logMAR（n = 20）。植入前平均UNVA为0.37±0.09 logMAR，取出前为0.38±0.13 logMAR，取出后为0.42±0.21 logMAR（n = 20）。植入前平均CDVA为 -0.01±0.04 logMAR，取出后为0.05±0.11 logMAR（n = 17）。取出前平均CDVA为0.04±0.07 logMAR，取出后为0.04±0.11 logMAR（n = 19）。植入前与取出后UDVA之间存在显著差异（p = 0.009），取出前与取出后UDVA之间也存在显著差异（p = 0.02）。所有患者（100%）植入前CDVA为20/20或更好，但取出后降至73.7%。60%（12/20）的患者取出后UDVA Snellen视力行数下降。植入前平均球镜等效屈光度（MRSE）为 -0.31±0.29 D，取出后为 +0.26±0.77 D（p = 0.007），注意到有远视性偏移。31.6%（6/19）的患者取出后远视性偏移未缓解。72.7%（16/22）的患者取出后出现角膜残余 haze。
尽管KAMRA角膜嵌体是可取出装置，但与植入前UDVA相比，患者取出后可能会出现角膜残余 haze、远视性偏移及UDVA下降。
