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Refractive corneal inlay implantation outcomes: a preliminary systematic review

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Abstract

Purpose

To review all case series of refractive corneal inlay implantation: Flexivue (Presbia, Netherlands), Invue (BioVision, Brügg, Switzerland) and Icolens (Neoptics, Hünenberg, Switzerland) performed in presbyopia patients and to evaluate the reported visual outcomes. In addition, our aim is to provide assessment for complications and to report the satisfaction rates.

Methods

PubMed, Web of Science and Scopus databases were consulted using “refractive corneal inlay”, “Flexivue Inlay”, “Invue Inlay” and “Icolens inlay” as keywords. 147 articles were found, and they were assessed considering the inclusion and exclusion criteria. After filtering, this systemic review included ten articles, published between 2011 and 2020.

Results

308 eyes from 308 participants were enrolled in this systematic review. Mean maximum follow-up was 13.9 months. Nine of the ten case series included used femtosecond laser for the corneal pocket creation. Mean pocket depth was 293.75 µm. 77.5% of the eyes reported a postoperative uncorrected near visual acuity of 20/32 or better, and 19.20% of the inlay-implanted eyes achieved an uncorrected distance visual acuity of 20/20 or better. The most prominent complications were halos, pain, photophobia, and poor distance visual acuity. 27 eyes (8.7%) had to be explanted due to complications, such as near-distance spectacle dependence or blurred distance vision.

Conclusion

Refractive corneal inlay outcomes demonstrated high efficacy, safety, and satisfaction rates. Furthermore, it is a reversible technique. However, the findings must be viewed with caution due potential conflict of interest. Further research with higher sample size is needed to validate these findings.

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Funding

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Authors and Affiliations

  1. Department of Physics of Condensed Matter, Optics Area, University of Seville, Reina Mercedes St., Seville, Spain

    José-María Sánchez-González

  2. Department of Ophthalmology and Optometry, Tecnolaser Clinic Vision, Seville, Spain

    José-María Sánchez-González

  3. Department of Ophthalmology, Fondazione Banca Degli Occhi Del Veneto Onlus, Zelarino, Venezia, Italy

    Davide Borroni

  4. Department of Doctoral Studies, Riga Stradins University, Riga, Latvia

    Davide Borroni

  5. Department of Ophthalmology, Hospital Regional Universitario de Málaga, Málaga, Spain

    Rahul Rachwani-Anil

  6. Department of Ophthalmology, Hospital Virgen de la Nieves, Granada, Spain

    Carlos Rocha-de-Lossada

  7. Department of Ophthalmology (Qvision), Vithas Virgen del Mar Hospital, Almería, Spain

    Carlos Rocha-de-Lossada

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  1. José-María Sánchez-González
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  2. Davide Borroni
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  4. Carlos Rocha-de-Lossada
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Corresponding author

Correspondence to José-María Sánchez-González.

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All authors declare no competing interest.

Ethical approval

This study was conducted in accordance with the tenets of the Helsinki Declaration and obtained Institutional Review Board approval.

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All patients included in this work were adequately informed verbally and in writing of the benefits, characteristics, and risks of the surgeries. All patients signed an informed consent prior to the surgery and after the interview performed with the ophthalmologist.

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Sánchez-González, JM., Borroni, D., Rachwani-Anil, R. et al. Refractive corneal inlay implantation outcomes: a preliminary systematic review. Int Ophthalmol 42, 713–722 (2022). https://doi.org/10.1007/s10792-021-02024-4

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  • DOI: https://doi.org/10.1007/s10792-021-02024-4

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