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Gunther Grabner - One of the best experts on this subject based on the ideXlab platform.

  • long term outcomes after monocular corneal inlay implantation for the surgical compensation of Presbyopia
    Journal of Cataract and Refractive Surgery, 2015
    Co-Authors: Alois K Dexl, Orang Seyeddain, Wolfgang Riha, Gerlinde Jell, Clemens Strohmaier, Theresa Ruckl, Alexander Bachernegg, Gunther Grabner
    Abstract:

    PURPOSE: To evaluate long-term outcomes of small-aperture corneal inlay implantation for the surgical compensation of Presbyopia. SETTING: Paracelsus Medical University, Salzburg, Austria. DESIGN: Prospective interventional cohort study. METHODS: Monocular implantation of a Kamra small-aperture inlay (model ACI7000) (1.6 mm central aperture) was performed in emmetropic presbyopic eyes. The preoperative and postoperative parameters included monocular and binocular uncorrected (UDVA) and corrected (CDVA) distance visual acuities, uncorrected intermediate visual acuity (UIVA), and uncorrected (UNVA) and corrected (CNVA) near visual acuities; refraction; patient satisfaction; and complications. RESULTS: From September 4, 2006, to May 21, 2007, a small-aperture inlay (1.6 mm central aperture) was implanted in 32 emmetropic presbyopic eyes. The mean binocular uncorrected visual acuities improved as follows: UNVA from Jaeger (J) 6 ± 1.2 lines (∼20/50) to J2 ± 1.8 lines (∼20/25) (P < .001) and UIVA from 0.2 logMAR ± 1.3 lines (∼20/32) to 0.1 logMAR ± 1.3 lines (∼20/25) (P = .04). The UDVA decreased from -0.2 logMAR ± 0.2 lines (∼20/12.5) to -0.1 logMAR ± 0.6 lines (∼20/16) (P < .001). At 60 months, 74.2% of patients had a UNVA of J3 (∼20/32) or better, 87.1% had a UIVA of 0.2 logMAR (∼20/32) or better, and 93.5% had a UDVA of 0.0 logMAR (∼20/20) or better. One inlay was removed after 36 months because of patient dissatisfaction with vision after a hyperopic shift in the surgical eye, with no loss of CDVA or CNVA 2 years after removal. CONCLUSION: Long-term results of monocular corneal inlay implantation indicate increased UNVA and UIVA and slightly compromised UDVA in emmetropic presbyopic eyes. FINANCIAL DISCLOSURE: Dr. Grabner was reimbursed for travel expenses from Acufocus. Dr. Riha is a consultant to Acufocus. No other author has a financial or proprietary interest in any material or method mentioned.

  • implantable inlay devices for Presbyopia the evidence to date
    Clinical Ophthalmology, 2015
    Co-Authors: E M Arlt, Eva Maria Krall, Sarah Moussa, Gunther Grabner, Alois K Dexl
    Abstract:

    By 2020, it is estimated that 2.1 billion people will be presbyopic, and the demand for spectacle independence in this group is growing. This review article provides an overview of the three commercially available corneal inlays for the correction of Presbyopia. Safety, efficacy, visual outcomes, and complications are analyzed for all three inlays according to published peer-reviewed data.

  • femtosecond laser assisted small aperture corneal inlay implantation for corneal compensation of Presbyopia two year follow up
    Journal of Cataract and Refractive Surgery, 2013
    Co-Authors: Orang Seyeddain, Gunther Grabner, Wolfgang Riha, Theresa Ruckl, Alexander Bachernegg, Herbert A Reitsamer, Alois K Dexl
    Abstract:

    PURPOSE: To report the 2-year postoperative safety and efficacy outcomes after monocular Kamra corneal inlay (ACI7000PDT) implantation in femtosecond laser-created corneal pockets of emmetropic presbyopic patients to improve near and intermediate vision. SETTING: University Eye Clinic, Paracelsus Medical University, Salzburg, Austria. DESIGN: Prospective interventional case series. METHODS: Patients had corneal inlay implantation in the nondominant eye. Emmetropic presbyopic patients between 45 and 60 years old with an uncorrected distance visual acuity (UDVA) of 20/20 or better in both eyes and without additional ocular pathology were eligible. Contrast sensitivity, visual field examinations, endothelial cell count (ECC), and central corneal thickness (CCT) measurements were assessed preoperatively and 12 and 24 months postoperatively. The UDVA, uncorrected intermediate visual acuity (UIVA), and near visual acuity (UNVA) were assessed preoperatively and 1 day, 1 week, and 1, 3, 6, 9, 12, 18, and 24 months postoperatively. The minimum postoperative follow-up was 24 months. RESULTS: After 24 months, the mean binocular UNVA improved from 20/50 to 20/25; 20 patients (83%) had a UNVA of 20/25 or better. The mean binocular UIVA was 20/20. The mean UDVA was 20/20 in the surgical eye and 20/16 binocularly after 24 months. Contrast sensitivity under photopic and mesopic conditions remained in the range of the normal population. No patient had detectable central visual field defect. No inlay was explanted. No inflammatory reactions were observed. The ECC and CCT remained stable. CONCLUSION: The corneal inlay implanted in femtosecond laser-created pockets was effective and safe for the corneal compensation of Presbyopia in emmetropic patients after 24 months. FINANCIAL DISCLOSURE: Acufocus Inc., Irvine, California, USA, financially supports the Research Foundation for Promoting Ophthalmology, Salzburg, Austria, as the clinical research center of the University Eye Clinic (Paracelsus Medical University). Dr. Grabner received travel expenses from Acufocus, Inc. Dr. Riha currently also works as a clinical application specialist for Acufocus, Inc. No other author has a financial or proprietary interest in any material or method mentioned.

  • reading performance and patient satisfaction after corneal inlay implantation for Presbyopia correction two year follow up
    Journal of Cataract and Refractive Surgery, 2012
    Co-Authors: Alois K Dexl, Orang Seyeddain, Wolfgang Riha, Theresa Ruckl, Alexander Bachernegg, Martin Emesz, Josef Ruckhofer, Gunther Grabner
    Abstract:

    PURPOSE: To evaluate change in reading performance parameters after monocular Kamra corneal inlay implantation for the surgical correction of Presbyopia. SETTING: University surgical outpatient center. DESIGN: Prospective interventional case series. METHODS: A corneal inlay was implanted in the nondominant eye. Naturally emmetropic and presbyopic patients between 45 years and 60 years old with an uncorrected distance visual acuity of at least 20/20 in both eyes without additional ocular pathology were eligible for inclusion. Bilateral uncorrected reading acuity, reading distance, mean and maximum reading speed, and the smallest log-scaled print size (lower case letter of a Radner reading chart) were evaluated using the Salzburg Reading Desk. The minimum postoperative follow-up was 24 months. RESULTS: Twenty-four patients were enrolled. The mean reading distance was 46.7 cm G 6.3 (SD) preoperatively and 39.5 G 6.4 cm 24 months postoperatively (P<.001). The mean reading acuity at best distance improved (0.33 G 0.13 logRAD versus 0.23 G 0.11 logRAD) (PZ.004). The mean reading speed increased from 141 G 20 words per minute (wpm) to 146 G 20 wpm, respectively (PZ.261), and the mean maximum reading speed from 171 G 28 wpm to 180 G 22 wpm, respectively (PZ.110). The smallest print size improved from 1.50 G 0.42 mm to 1.01 G 0.22 mm, respectively (P<.001). CONCLUSION: Improving the depth of focus by monocular implantation of a small-aperture optic caused statistically significant changes in all tested reading performance parameters except reading speed metrics in emmetropic presbyopic patients.

  • reading performance after implantation of a modified corneal inlay design for the surgical correction of Presbyopia 1 year follow up
    American Journal of Ophthalmology, 2012
    Co-Authors: Alois K Dexl, Orang Seyeddain, Wolfgang Riha, Melchior Hohensinn, W Hitzl, Theresa Ruckl, Gunther Grabner
    Abstract:

    PURPOSE: To evaluate change in different reading performance parameters after monocular ACI7000PDT corneal inlay implantation for the improvement of near and intermediate vision. DESIGN: Prospective, interventional case series. METHODS: Twenty-four patients were scheduled for corneal inlay implantation in the nondominant eye in a university outpatient surgery center. Naturally emmetropic and presbyopic patients between 45 and 60 years of age, with uncorrected distance visual acuity of at least 20/20 in both eyes, without any additional ocular pathology were eligible for inclusion. Bilateral uncorrected reading acuity, mean and maximum reading speed, and smallest log-scaled print size were evaluated with the standardized Radner Reading Charts. Measurements of reading parameters and reading distance were performed with the Salzburg Reading Desk (SRD). Minimum postoperative follow-up was 12 months. RESULTS: The reading desk results showed significant changes in each parameter tested. After 12 months the mean reading distance changed from the preoperative value of 46.7 cm (95% CI: 44.1-49.3) to 42.8 cm (95% CI: 40.3-45.3, P < .004), and the mean reading acuity "at best distance" improved from 0.33 logRAD (95% CI: 0.27-0.39) to 0.24 logRAD (95% CI: 0.20-0.28, P < .005). Mean reading speed increased from 141 words per minute (wpm, 95% CI: 133-150) to 156 wpm (95% CI: 145-167, P < .003), maximum reading speed increased from 171 wpm (95% CI: 159-183) to 196 wpm (95% CI: 180-212, P = .001), and the smallest print size improved from 1.50 mm (95% CI: 1.32-1.67) to 1.12 mm (95% CI: 1.03-1.22, P < .001). CONCLUSIONS: After ACI7000PDT implantation, there were significant changes in all tested reading performance parameters in emmetropic presbyopic patients. These 1-year results indicate that the inlay seems to be an effective treatment for Presbyopia.

Alois K Dexl - One of the best experts on this subject based on the ideXlab platform.

  • long term outcomes after monocular corneal inlay implantation for the surgical compensation of Presbyopia
    Journal of Cataract and Refractive Surgery, 2015
    Co-Authors: Alois K Dexl, Orang Seyeddain, Wolfgang Riha, Gerlinde Jell, Clemens Strohmaier, Theresa Ruckl, Alexander Bachernegg, Gunther Grabner
    Abstract:

    PURPOSE: To evaluate long-term outcomes of small-aperture corneal inlay implantation for the surgical compensation of Presbyopia. SETTING: Paracelsus Medical University, Salzburg, Austria. DESIGN: Prospective interventional cohort study. METHODS: Monocular implantation of a Kamra small-aperture inlay (model ACI7000) (1.6 mm central aperture) was performed in emmetropic presbyopic eyes. The preoperative and postoperative parameters included monocular and binocular uncorrected (UDVA) and corrected (CDVA) distance visual acuities, uncorrected intermediate visual acuity (UIVA), and uncorrected (UNVA) and corrected (CNVA) near visual acuities; refraction; patient satisfaction; and complications. RESULTS: From September 4, 2006, to May 21, 2007, a small-aperture inlay (1.6 mm central aperture) was implanted in 32 emmetropic presbyopic eyes. The mean binocular uncorrected visual acuities improved as follows: UNVA from Jaeger (J) 6 ± 1.2 lines (∼20/50) to J2 ± 1.8 lines (∼20/25) (P < .001) and UIVA from 0.2 logMAR ± 1.3 lines (∼20/32) to 0.1 logMAR ± 1.3 lines (∼20/25) (P = .04). The UDVA decreased from -0.2 logMAR ± 0.2 lines (∼20/12.5) to -0.1 logMAR ± 0.6 lines (∼20/16) (P < .001). At 60 months, 74.2% of patients had a UNVA of J3 (∼20/32) or better, 87.1% had a UIVA of 0.2 logMAR (∼20/32) or better, and 93.5% had a UDVA of 0.0 logMAR (∼20/20) or better. One inlay was removed after 36 months because of patient dissatisfaction with vision after a hyperopic shift in the surgical eye, with no loss of CDVA or CNVA 2 years after removal. CONCLUSION: Long-term results of monocular corneal inlay implantation indicate increased UNVA and UIVA and slightly compromised UDVA in emmetropic presbyopic eyes. FINANCIAL DISCLOSURE: Dr. Grabner was reimbursed for travel expenses from Acufocus. Dr. Riha is a consultant to Acufocus. No other author has a financial or proprietary interest in any material or method mentioned.

  • implantable inlay devices for Presbyopia the evidence to date
    Clinical Ophthalmology, 2015
    Co-Authors: E M Arlt, Eva Maria Krall, Sarah Moussa, Gunther Grabner, Alois K Dexl
    Abstract:

    By 2020, it is estimated that 2.1 billion people will be presbyopic, and the demand for spectacle independence in this group is growing. This review article provides an overview of the three commercially available corneal inlays for the correction of Presbyopia. Safety, efficacy, visual outcomes, and complications are analyzed for all three inlays according to published peer-reviewed data.

  • femtosecond laser assisted small aperture corneal inlay implantation for corneal compensation of Presbyopia two year follow up
    Journal of Cataract and Refractive Surgery, 2013
    Co-Authors: Orang Seyeddain, Gunther Grabner, Wolfgang Riha, Theresa Ruckl, Alexander Bachernegg, Herbert A Reitsamer, Alois K Dexl
    Abstract:

    PURPOSE: To report the 2-year postoperative safety and efficacy outcomes after monocular Kamra corneal inlay (ACI7000PDT) implantation in femtosecond laser-created corneal pockets of emmetropic presbyopic patients to improve near and intermediate vision. SETTING: University Eye Clinic, Paracelsus Medical University, Salzburg, Austria. DESIGN: Prospective interventional case series. METHODS: Patients had corneal inlay implantation in the nondominant eye. Emmetropic presbyopic patients between 45 and 60 years old with an uncorrected distance visual acuity (UDVA) of 20/20 or better in both eyes and without additional ocular pathology were eligible. Contrast sensitivity, visual field examinations, endothelial cell count (ECC), and central corneal thickness (CCT) measurements were assessed preoperatively and 12 and 24 months postoperatively. The UDVA, uncorrected intermediate visual acuity (UIVA), and near visual acuity (UNVA) were assessed preoperatively and 1 day, 1 week, and 1, 3, 6, 9, 12, 18, and 24 months postoperatively. The minimum postoperative follow-up was 24 months. RESULTS: After 24 months, the mean binocular UNVA improved from 20/50 to 20/25; 20 patients (83%) had a UNVA of 20/25 or better. The mean binocular UIVA was 20/20. The mean UDVA was 20/20 in the surgical eye and 20/16 binocularly after 24 months. Contrast sensitivity under photopic and mesopic conditions remained in the range of the normal population. No patient had detectable central visual field defect. No inlay was explanted. No inflammatory reactions were observed. The ECC and CCT remained stable. CONCLUSION: The corneal inlay implanted in femtosecond laser-created pockets was effective and safe for the corneal compensation of Presbyopia in emmetropic patients after 24 months. FINANCIAL DISCLOSURE: Acufocus Inc., Irvine, California, USA, financially supports the Research Foundation for Promoting Ophthalmology, Salzburg, Austria, as the clinical research center of the University Eye Clinic (Paracelsus Medical University). Dr. Grabner received travel expenses from Acufocus, Inc. Dr. Riha currently also works as a clinical application specialist for Acufocus, Inc. No other author has a financial or proprietary interest in any material or method mentioned.

  • reading performance and patient satisfaction after corneal inlay implantation for Presbyopia correction two year follow up
    Journal of Cataract and Refractive Surgery, 2012
    Co-Authors: Alois K Dexl, Orang Seyeddain, Wolfgang Riha, Theresa Ruckl, Alexander Bachernegg, Martin Emesz, Josef Ruckhofer, Gunther Grabner
    Abstract:

    PURPOSE: To evaluate change in reading performance parameters after monocular Kamra corneal inlay implantation for the surgical correction of Presbyopia. SETTING: University surgical outpatient center. DESIGN: Prospective interventional case series. METHODS: A corneal inlay was implanted in the nondominant eye. Naturally emmetropic and presbyopic patients between 45 years and 60 years old with an uncorrected distance visual acuity of at least 20/20 in both eyes without additional ocular pathology were eligible for inclusion. Bilateral uncorrected reading acuity, reading distance, mean and maximum reading speed, and the smallest log-scaled print size (lower case letter of a Radner reading chart) were evaluated using the Salzburg Reading Desk. The minimum postoperative follow-up was 24 months. RESULTS: Twenty-four patients were enrolled. The mean reading distance was 46.7 cm G 6.3 (SD) preoperatively and 39.5 G 6.4 cm 24 months postoperatively (P<.001). The mean reading acuity at best distance improved (0.33 G 0.13 logRAD versus 0.23 G 0.11 logRAD) (PZ.004). The mean reading speed increased from 141 G 20 words per minute (wpm) to 146 G 20 wpm, respectively (PZ.261), and the mean maximum reading speed from 171 G 28 wpm to 180 G 22 wpm, respectively (PZ.110). The smallest print size improved from 1.50 G 0.42 mm to 1.01 G 0.22 mm, respectively (P<.001). CONCLUSION: Improving the depth of focus by monocular implantation of a small-aperture optic caused statistically significant changes in all tested reading performance parameters except reading speed metrics in emmetropic presbyopic patients.

  • reading performance after implantation of a modified corneal inlay design for the surgical correction of Presbyopia 1 year follow up
    American Journal of Ophthalmology, 2012
    Co-Authors: Alois K Dexl, Orang Seyeddain, Wolfgang Riha, Melchior Hohensinn, W Hitzl, Theresa Ruckl, Gunther Grabner
    Abstract:

    PURPOSE: To evaluate change in different reading performance parameters after monocular ACI7000PDT corneal inlay implantation for the improvement of near and intermediate vision. DESIGN: Prospective, interventional case series. METHODS: Twenty-four patients were scheduled for corneal inlay implantation in the nondominant eye in a university outpatient surgery center. Naturally emmetropic and presbyopic patients between 45 and 60 years of age, with uncorrected distance visual acuity of at least 20/20 in both eyes, without any additional ocular pathology were eligible for inclusion. Bilateral uncorrected reading acuity, mean and maximum reading speed, and smallest log-scaled print size were evaluated with the standardized Radner Reading Charts. Measurements of reading parameters and reading distance were performed with the Salzburg Reading Desk (SRD). Minimum postoperative follow-up was 12 months. RESULTS: The reading desk results showed significant changes in each parameter tested. After 12 months the mean reading distance changed from the preoperative value of 46.7 cm (95% CI: 44.1-49.3) to 42.8 cm (95% CI: 40.3-45.3, P < .004), and the mean reading acuity "at best distance" improved from 0.33 logRAD (95% CI: 0.27-0.39) to 0.24 logRAD (95% CI: 0.20-0.28, P < .005). Mean reading speed increased from 141 words per minute (wpm, 95% CI: 133-150) to 156 wpm (95% CI: 145-167, P < .003), maximum reading speed increased from 171 wpm (95% CI: 159-183) to 196 wpm (95% CI: 180-212, P = .001), and the smallest print size improved from 1.50 mm (95% CI: 1.32-1.67) to 1.12 mm (95% CI: 1.03-1.22, P < .001). CONCLUSIONS: After ACI7000PDT implantation, there were significant changes in all tested reading performance parameters in emmetropic presbyopic patients. These 1-year results indicate that the inlay seems to be an effective treatment for Presbyopia.

Orang Seyeddain - One of the best experts on this subject based on the ideXlab platform.

  • long term outcomes after monocular corneal inlay implantation for the surgical compensation of Presbyopia
    Journal of Cataract and Refractive Surgery, 2015
    Co-Authors: Alois K Dexl, Orang Seyeddain, Wolfgang Riha, Gerlinde Jell, Clemens Strohmaier, Theresa Ruckl, Alexander Bachernegg, Gunther Grabner
    Abstract:

    PURPOSE: To evaluate long-term outcomes of small-aperture corneal inlay implantation for the surgical compensation of Presbyopia. SETTING: Paracelsus Medical University, Salzburg, Austria. DESIGN: Prospective interventional cohort study. METHODS: Monocular implantation of a Kamra small-aperture inlay (model ACI7000) (1.6 mm central aperture) was performed in emmetropic presbyopic eyes. The preoperative and postoperative parameters included monocular and binocular uncorrected (UDVA) and corrected (CDVA) distance visual acuities, uncorrected intermediate visual acuity (UIVA), and uncorrected (UNVA) and corrected (CNVA) near visual acuities; refraction; patient satisfaction; and complications. RESULTS: From September 4, 2006, to May 21, 2007, a small-aperture inlay (1.6 mm central aperture) was implanted in 32 emmetropic presbyopic eyes. The mean binocular uncorrected visual acuities improved as follows: UNVA from Jaeger (J) 6 ± 1.2 lines (∼20/50) to J2 ± 1.8 lines (∼20/25) (P < .001) and UIVA from 0.2 logMAR ± 1.3 lines (∼20/32) to 0.1 logMAR ± 1.3 lines (∼20/25) (P = .04). The UDVA decreased from -0.2 logMAR ± 0.2 lines (∼20/12.5) to -0.1 logMAR ± 0.6 lines (∼20/16) (P < .001). At 60 months, 74.2% of patients had a UNVA of J3 (∼20/32) or better, 87.1% had a UIVA of 0.2 logMAR (∼20/32) or better, and 93.5% had a UDVA of 0.0 logMAR (∼20/20) or better. One inlay was removed after 36 months because of patient dissatisfaction with vision after a hyperopic shift in the surgical eye, with no loss of CDVA or CNVA 2 years after removal. CONCLUSION: Long-term results of monocular corneal inlay implantation indicate increased UNVA and UIVA and slightly compromised UDVA in emmetropic presbyopic eyes. FINANCIAL DISCLOSURE: Dr. Grabner was reimbursed for travel expenses from Acufocus. Dr. Riha is a consultant to Acufocus. No other author has a financial or proprietary interest in any material or method mentioned.

  • femtosecond laser assisted small aperture corneal inlay implantation for corneal compensation of Presbyopia two year follow up
    Journal of Cataract and Refractive Surgery, 2013
    Co-Authors: Orang Seyeddain, Gunther Grabner, Wolfgang Riha, Theresa Ruckl, Alexander Bachernegg, Herbert A Reitsamer, Alois K Dexl
    Abstract:

    PURPOSE: To report the 2-year postoperative safety and efficacy outcomes after monocular Kamra corneal inlay (ACI7000PDT) implantation in femtosecond laser-created corneal pockets of emmetropic presbyopic patients to improve near and intermediate vision. SETTING: University Eye Clinic, Paracelsus Medical University, Salzburg, Austria. DESIGN: Prospective interventional case series. METHODS: Patients had corneal inlay implantation in the nondominant eye. Emmetropic presbyopic patients between 45 and 60 years old with an uncorrected distance visual acuity (UDVA) of 20/20 or better in both eyes and without additional ocular pathology were eligible. Contrast sensitivity, visual field examinations, endothelial cell count (ECC), and central corneal thickness (CCT) measurements were assessed preoperatively and 12 and 24 months postoperatively. The UDVA, uncorrected intermediate visual acuity (UIVA), and near visual acuity (UNVA) were assessed preoperatively and 1 day, 1 week, and 1, 3, 6, 9, 12, 18, and 24 months postoperatively. The minimum postoperative follow-up was 24 months. RESULTS: After 24 months, the mean binocular UNVA improved from 20/50 to 20/25; 20 patients (83%) had a UNVA of 20/25 or better. The mean binocular UIVA was 20/20. The mean UDVA was 20/20 in the surgical eye and 20/16 binocularly after 24 months. Contrast sensitivity under photopic and mesopic conditions remained in the range of the normal population. No patient had detectable central visual field defect. No inlay was explanted. No inflammatory reactions were observed. The ECC and CCT remained stable. CONCLUSION: The corneal inlay implanted in femtosecond laser-created pockets was effective and safe for the corneal compensation of Presbyopia in emmetropic patients after 24 months. FINANCIAL DISCLOSURE: Acufocus Inc., Irvine, California, USA, financially supports the Research Foundation for Promoting Ophthalmology, Salzburg, Austria, as the clinical research center of the University Eye Clinic (Paracelsus Medical University). Dr. Grabner received travel expenses from Acufocus, Inc. Dr. Riha currently also works as a clinical application specialist for Acufocus, Inc. No other author has a financial or proprietary interest in any material or method mentioned.

  • reading performance and patient satisfaction after corneal inlay implantation for Presbyopia correction two year follow up
    Journal of Cataract and Refractive Surgery, 2012
    Co-Authors: Alois K Dexl, Orang Seyeddain, Wolfgang Riha, Theresa Ruckl, Alexander Bachernegg, Martin Emesz, Josef Ruckhofer, Gunther Grabner
    Abstract:

    PURPOSE: To evaluate change in reading performance parameters after monocular Kamra corneal inlay implantation for the surgical correction of Presbyopia. SETTING: University surgical outpatient center. DESIGN: Prospective interventional case series. METHODS: A corneal inlay was implanted in the nondominant eye. Naturally emmetropic and presbyopic patients between 45 years and 60 years old with an uncorrected distance visual acuity of at least 20/20 in both eyes without additional ocular pathology were eligible for inclusion. Bilateral uncorrected reading acuity, reading distance, mean and maximum reading speed, and the smallest log-scaled print size (lower case letter of a Radner reading chart) were evaluated using the Salzburg Reading Desk. The minimum postoperative follow-up was 24 months. RESULTS: Twenty-four patients were enrolled. The mean reading distance was 46.7 cm G 6.3 (SD) preoperatively and 39.5 G 6.4 cm 24 months postoperatively (P<.001). The mean reading acuity at best distance improved (0.33 G 0.13 logRAD versus 0.23 G 0.11 logRAD) (PZ.004). The mean reading speed increased from 141 G 20 words per minute (wpm) to 146 G 20 wpm, respectively (PZ.261), and the mean maximum reading speed from 171 G 28 wpm to 180 G 22 wpm, respectively (PZ.110). The smallest print size improved from 1.50 G 0.42 mm to 1.01 G 0.22 mm, respectively (P<.001). CONCLUSION: Improving the depth of focus by monocular implantation of a small-aperture optic caused statistically significant changes in all tested reading performance parameters except reading speed metrics in emmetropic presbyopic patients.

  • reading performance after implantation of a modified corneal inlay design for the surgical correction of Presbyopia 1 year follow up
    American Journal of Ophthalmology, 2012
    Co-Authors: Alois K Dexl, Orang Seyeddain, Wolfgang Riha, Melchior Hohensinn, W Hitzl, Theresa Ruckl, Gunther Grabner
    Abstract:

    PURPOSE: To evaluate change in different reading performance parameters after monocular ACI7000PDT corneal inlay implantation for the improvement of near and intermediate vision. DESIGN: Prospective, interventional case series. METHODS: Twenty-four patients were scheduled for corneal inlay implantation in the nondominant eye in a university outpatient surgery center. Naturally emmetropic and presbyopic patients between 45 and 60 years of age, with uncorrected distance visual acuity of at least 20/20 in both eyes, without any additional ocular pathology were eligible for inclusion. Bilateral uncorrected reading acuity, mean and maximum reading speed, and smallest log-scaled print size were evaluated with the standardized Radner Reading Charts. Measurements of reading parameters and reading distance were performed with the Salzburg Reading Desk (SRD). Minimum postoperative follow-up was 12 months. RESULTS: The reading desk results showed significant changes in each parameter tested. After 12 months the mean reading distance changed from the preoperative value of 46.7 cm (95% CI: 44.1-49.3) to 42.8 cm (95% CI: 40.3-45.3, P < .004), and the mean reading acuity "at best distance" improved from 0.33 logRAD (95% CI: 0.27-0.39) to 0.24 logRAD (95% CI: 0.20-0.28, P < .005). Mean reading speed increased from 141 words per minute (wpm, 95% CI: 133-150) to 156 wpm (95% CI: 145-167, P < .003), maximum reading speed increased from 171 wpm (95% CI: 159-183) to 196 wpm (95% CI: 180-212, P = .001), and the smallest print size improved from 1.50 mm (95% CI: 1.32-1.67) to 1.12 mm (95% CI: 1.03-1.22, P < .001). CONCLUSIONS: After ACI7000PDT implantation, there were significant changes in all tested reading performance parameters in emmetropic presbyopic patients. These 1-year results indicate that the inlay seems to be an effective treatment for Presbyopia.

  • small aperture corneal inlay for the correction of Presbyopia 3 year follow up
    Journal of Cataract and Refractive Surgery, 2012
    Co-Authors: Orang Seyeddain, Gunther Grabner, Wolfgang Riha, Melchior Hohensinn, Theresa Ruckl, Alois K Dexl
    Abstract:

    Purpose To report the 3-year postoperative safety and efficacy outcomes of the Acufocus corneal inlay. Setting University Eye Clinic, Paracelsus Medical University, Salzburg, Austria. Design Prospective nonrandomized noncomparative cohort study. Methods The corneal inlay was implanted in the nondominant eye of naturally emmetropic presbyopic patients. Refraction, uncorrected near (UNVA), intermediate (UIVA), and distance (UDVA) visual acuities; corrected distance visual acuity (CDVA); contrast sensitivity; visual fields; subjective patient satisfaction and symptoms; and operative and postoperative adverse events and complications were evaluated. Results The study enrolled 32 patients. The mean UNVA improved from Jaeger (J) 6 preoperatively to J1 at 3 years and the mean UIVA, from 20/40 to 20/25, respectively. At 3 years, 97% of eyes had a UNVA of J3 or better and 91% had a UIVA of 20/32 or better. The mean UDVA was 20/20, with all eyes achieving 20/32 or better. Nine eyes (28.3%) lost 1 line of CDVA, 1 eye (3.1%) lost more than 2 lines (3.8 lines), and 3 eyes (9.3%) gained 1 line. No inlay was explanted, and no inflammatory reactions were observed. At 3 years, 15.6% of patients reported severe night-vision problems and 6.3% (versus 87.5% preoperatively) reported being dependent on reading glasses. Conclusions These 3-year results support the safety and efficacy of the corneal inlay to correct Presbyopia in naturally emmetropic presbyopic patients. However, despite a significant gain in UNVA and UIVA, 28.3% of patients lost 1 line of CDVA. Financial Disclosure Acufocus, Inc., California, USA, financially supports the Research Foundation for Promoting Opthhalmology, Salzburg, Austria, as the clinical research center of the University Eye Clinic, Paracelsus Medical University, Salzburg. Dr. Grabner received travel expenses from Acufocus, Inc. Dr. Riha currently works as a clinical application specialist for Acufocus, Inc. Drs. Seyeddain, Hohensinn, Nix, Ruckl, and Dexl have no financial or proprietary interest in any material or method mentioned.

Wolfgang Riha - One of the best experts on this subject based on the ideXlab platform.

  • long term outcomes after monocular corneal inlay implantation for the surgical compensation of Presbyopia
    Journal of Cataract and Refractive Surgery, 2015
    Co-Authors: Alois K Dexl, Orang Seyeddain, Wolfgang Riha, Gerlinde Jell, Clemens Strohmaier, Theresa Ruckl, Alexander Bachernegg, Gunther Grabner
    Abstract:

    PURPOSE: To evaluate long-term outcomes of small-aperture corneal inlay implantation for the surgical compensation of Presbyopia. SETTING: Paracelsus Medical University, Salzburg, Austria. DESIGN: Prospective interventional cohort study. METHODS: Monocular implantation of a Kamra small-aperture inlay (model ACI7000) (1.6 mm central aperture) was performed in emmetropic presbyopic eyes. The preoperative and postoperative parameters included monocular and binocular uncorrected (UDVA) and corrected (CDVA) distance visual acuities, uncorrected intermediate visual acuity (UIVA), and uncorrected (UNVA) and corrected (CNVA) near visual acuities; refraction; patient satisfaction; and complications. RESULTS: From September 4, 2006, to May 21, 2007, a small-aperture inlay (1.6 mm central aperture) was implanted in 32 emmetropic presbyopic eyes. The mean binocular uncorrected visual acuities improved as follows: UNVA from Jaeger (J) 6 ± 1.2 lines (∼20/50) to J2 ± 1.8 lines (∼20/25) (P < .001) and UIVA from 0.2 logMAR ± 1.3 lines (∼20/32) to 0.1 logMAR ± 1.3 lines (∼20/25) (P = .04). The UDVA decreased from -0.2 logMAR ± 0.2 lines (∼20/12.5) to -0.1 logMAR ± 0.6 lines (∼20/16) (P < .001). At 60 months, 74.2% of patients had a UNVA of J3 (∼20/32) or better, 87.1% had a UIVA of 0.2 logMAR (∼20/32) or better, and 93.5% had a UDVA of 0.0 logMAR (∼20/20) or better. One inlay was removed after 36 months because of patient dissatisfaction with vision after a hyperopic shift in the surgical eye, with no loss of CDVA or CNVA 2 years after removal. CONCLUSION: Long-term results of monocular corneal inlay implantation indicate increased UNVA and UIVA and slightly compromised UDVA in emmetropic presbyopic eyes. FINANCIAL DISCLOSURE: Dr. Grabner was reimbursed for travel expenses from Acufocus. Dr. Riha is a consultant to Acufocus. No other author has a financial or proprietary interest in any material or method mentioned.

  • femtosecond laser assisted small aperture corneal inlay implantation for corneal compensation of Presbyopia two year follow up
    Journal of Cataract and Refractive Surgery, 2013
    Co-Authors: Orang Seyeddain, Gunther Grabner, Wolfgang Riha, Theresa Ruckl, Alexander Bachernegg, Herbert A Reitsamer, Alois K Dexl
    Abstract:

    PURPOSE: To report the 2-year postoperative safety and efficacy outcomes after monocular Kamra corneal inlay (ACI7000PDT) implantation in femtosecond laser-created corneal pockets of emmetropic presbyopic patients to improve near and intermediate vision. SETTING: University Eye Clinic, Paracelsus Medical University, Salzburg, Austria. DESIGN: Prospective interventional case series. METHODS: Patients had corneal inlay implantation in the nondominant eye. Emmetropic presbyopic patients between 45 and 60 years old with an uncorrected distance visual acuity (UDVA) of 20/20 or better in both eyes and without additional ocular pathology were eligible. Contrast sensitivity, visual field examinations, endothelial cell count (ECC), and central corneal thickness (CCT) measurements were assessed preoperatively and 12 and 24 months postoperatively. The UDVA, uncorrected intermediate visual acuity (UIVA), and near visual acuity (UNVA) were assessed preoperatively and 1 day, 1 week, and 1, 3, 6, 9, 12, 18, and 24 months postoperatively. The minimum postoperative follow-up was 24 months. RESULTS: After 24 months, the mean binocular UNVA improved from 20/50 to 20/25; 20 patients (83%) had a UNVA of 20/25 or better. The mean binocular UIVA was 20/20. The mean UDVA was 20/20 in the surgical eye and 20/16 binocularly after 24 months. Contrast sensitivity under photopic and mesopic conditions remained in the range of the normal population. No patient had detectable central visual field defect. No inlay was explanted. No inflammatory reactions were observed. The ECC and CCT remained stable. CONCLUSION: The corneal inlay implanted in femtosecond laser-created pockets was effective and safe for the corneal compensation of Presbyopia in emmetropic patients after 24 months. FINANCIAL DISCLOSURE: Acufocus Inc., Irvine, California, USA, financially supports the Research Foundation for Promoting Ophthalmology, Salzburg, Austria, as the clinical research center of the University Eye Clinic (Paracelsus Medical University). Dr. Grabner received travel expenses from Acufocus, Inc. Dr. Riha currently also works as a clinical application specialist for Acufocus, Inc. No other author has a financial or proprietary interest in any material or method mentioned.

  • reading performance and patient satisfaction after corneal inlay implantation for Presbyopia correction two year follow up
    Journal of Cataract and Refractive Surgery, 2012
    Co-Authors: Alois K Dexl, Orang Seyeddain, Wolfgang Riha, Theresa Ruckl, Alexander Bachernegg, Martin Emesz, Josef Ruckhofer, Gunther Grabner
    Abstract:

    PURPOSE: To evaluate change in reading performance parameters after monocular Kamra corneal inlay implantation for the surgical correction of Presbyopia. SETTING: University surgical outpatient center. DESIGN: Prospective interventional case series. METHODS: A corneal inlay was implanted in the nondominant eye. Naturally emmetropic and presbyopic patients between 45 years and 60 years old with an uncorrected distance visual acuity of at least 20/20 in both eyes without additional ocular pathology were eligible for inclusion. Bilateral uncorrected reading acuity, reading distance, mean and maximum reading speed, and the smallest log-scaled print size (lower case letter of a Radner reading chart) were evaluated using the Salzburg Reading Desk. The minimum postoperative follow-up was 24 months. RESULTS: Twenty-four patients were enrolled. The mean reading distance was 46.7 cm G 6.3 (SD) preoperatively and 39.5 G 6.4 cm 24 months postoperatively (P<.001). The mean reading acuity at best distance improved (0.33 G 0.13 logRAD versus 0.23 G 0.11 logRAD) (PZ.004). The mean reading speed increased from 141 G 20 words per minute (wpm) to 146 G 20 wpm, respectively (PZ.261), and the mean maximum reading speed from 171 G 28 wpm to 180 G 22 wpm, respectively (PZ.110). The smallest print size improved from 1.50 G 0.42 mm to 1.01 G 0.22 mm, respectively (P<.001). CONCLUSION: Improving the depth of focus by monocular implantation of a small-aperture optic caused statistically significant changes in all tested reading performance parameters except reading speed metrics in emmetropic presbyopic patients.

  • reading performance after implantation of a modified corneal inlay design for the surgical correction of Presbyopia 1 year follow up
    American Journal of Ophthalmology, 2012
    Co-Authors: Alois K Dexl, Orang Seyeddain, Wolfgang Riha, Melchior Hohensinn, W Hitzl, Theresa Ruckl, Gunther Grabner
    Abstract:

    PURPOSE: To evaluate change in different reading performance parameters after monocular ACI7000PDT corneal inlay implantation for the improvement of near and intermediate vision. DESIGN: Prospective, interventional case series. METHODS: Twenty-four patients were scheduled for corneal inlay implantation in the nondominant eye in a university outpatient surgery center. Naturally emmetropic and presbyopic patients between 45 and 60 years of age, with uncorrected distance visual acuity of at least 20/20 in both eyes, without any additional ocular pathology were eligible for inclusion. Bilateral uncorrected reading acuity, mean and maximum reading speed, and smallest log-scaled print size were evaluated with the standardized Radner Reading Charts. Measurements of reading parameters and reading distance were performed with the Salzburg Reading Desk (SRD). Minimum postoperative follow-up was 12 months. RESULTS: The reading desk results showed significant changes in each parameter tested. After 12 months the mean reading distance changed from the preoperative value of 46.7 cm (95% CI: 44.1-49.3) to 42.8 cm (95% CI: 40.3-45.3, P < .004), and the mean reading acuity "at best distance" improved from 0.33 logRAD (95% CI: 0.27-0.39) to 0.24 logRAD (95% CI: 0.20-0.28, P < .005). Mean reading speed increased from 141 words per minute (wpm, 95% CI: 133-150) to 156 wpm (95% CI: 145-167, P < .003), maximum reading speed increased from 171 wpm (95% CI: 159-183) to 196 wpm (95% CI: 180-212, P = .001), and the smallest print size improved from 1.50 mm (95% CI: 1.32-1.67) to 1.12 mm (95% CI: 1.03-1.22, P < .001). CONCLUSIONS: After ACI7000PDT implantation, there were significant changes in all tested reading performance parameters in emmetropic presbyopic patients. These 1-year results indicate that the inlay seems to be an effective treatment for Presbyopia.

  • small aperture corneal inlay for the correction of Presbyopia 3 year follow up
    Journal of Cataract and Refractive Surgery, 2012
    Co-Authors: Orang Seyeddain, Gunther Grabner, Wolfgang Riha, Melchior Hohensinn, Theresa Ruckl, Alois K Dexl
    Abstract:

    Purpose To report the 3-year postoperative safety and efficacy outcomes of the Acufocus corneal inlay. Setting University Eye Clinic, Paracelsus Medical University, Salzburg, Austria. Design Prospective nonrandomized noncomparative cohort study. Methods The corneal inlay was implanted in the nondominant eye of naturally emmetropic presbyopic patients. Refraction, uncorrected near (UNVA), intermediate (UIVA), and distance (UDVA) visual acuities; corrected distance visual acuity (CDVA); contrast sensitivity; visual fields; subjective patient satisfaction and symptoms; and operative and postoperative adverse events and complications were evaluated. Results The study enrolled 32 patients. The mean UNVA improved from Jaeger (J) 6 preoperatively to J1 at 3 years and the mean UIVA, from 20/40 to 20/25, respectively. At 3 years, 97% of eyes had a UNVA of J3 or better and 91% had a UIVA of 20/32 or better. The mean UDVA was 20/20, with all eyes achieving 20/32 or better. Nine eyes (28.3%) lost 1 line of CDVA, 1 eye (3.1%) lost more than 2 lines (3.8 lines), and 3 eyes (9.3%) gained 1 line. No inlay was explanted, and no inflammatory reactions were observed. At 3 years, 15.6% of patients reported severe night-vision problems and 6.3% (versus 87.5% preoperatively) reported being dependent on reading glasses. Conclusions These 3-year results support the safety and efficacy of the corneal inlay to correct Presbyopia in naturally emmetropic presbyopic patients. However, despite a significant gain in UNVA and UIVA, 28.3% of patients lost 1 line of CDVA. Financial Disclosure Acufocus, Inc., California, USA, financially supports the Research Foundation for Promoting Opthhalmology, Salzburg, Austria, as the clinical research center of the University Eye Clinic, Paracelsus Medical University, Salzburg. Dr. Grabner received travel expenses from Acufocus, Inc. Dr. Riha currently works as a clinical application specialist for Acufocus, Inc. Drs. Seyeddain, Hohensinn, Nix, Ruckl, and Dexl have no financial or proprietary interest in any material or method mentioned.

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  • the global burden of potential productivity loss from uncorrected Presbyopia
    Ophthalmology, 2015
    Co-Authors: Brien A. Holden, Kovin Naidoo, Kevin D. Frick, David A Wilson
    Abstract:

    Purpose The onset of Presbyopia in middle adulthood results in potential losses in productivity among otherwise healthy adults if uncorrected or undercorrected. The economic burden could be significant in lower-income countries, where up to 94% of cases may be uncorrected or undercorrected. This study estimates the global burden of potential productivity lost because of uncorrected functional Presbyopia. Design Population data from the US Census Bureau were combined with the estimated Presbyopia prevalence, age of onset, employment rate, gross domestic product (GDP) per capita in current US dollars, and near vision impairment disability weights from the Global Burden of Disease 2010 study to estimate the global loss of productivity from uncorrected and undercorrected Presbyopia in each country in 2011. To allow comparison with earlier work, we also calculated the loss with the conservative assumption that the contribution to productivity extends only up to 50 years of age. Participants The economic modeling did not require the use of subjects. Methods We estimated the number of cases of uncorrected or undercorrected Presbyopia in each country among the working-age population. The number of working-age cases was multiplied by the labor force participation rate, the employment rate, a disability weight, and the GDP per capita to estimate the potential loss of GDP due to Presbyopia. Main Outcome Measures The outcome being measured is the lost productivity in 2011 US dollars resulting from uncorrected or undercorrected Presbyopia. Results There were an estimated 1.272 billion cases of Presbyopia worldwide in 2011. A total of 244 million cases, uncorrected or undercorrected among people aged Conclusions Even with conservative assumptions regarding the productive population, Presbyopia is a significant burden on productivity, and correction would have a significant impact on productivity in lower-income countries.

  • Global Vision Impairment Due to Uncorrected Presbyopia
    Archives of Ophthalmology, 2008
    Co-Authors: Brien A. Holden, Timothy R Fricke, Eric B Papas, Anthea Burnett, S. May Ho, Reg Wong, Gerhard Schlenther, Sonja Cronjé, Kovin Naidoo, Kevin D. Frick
    Abstract:

    erage rate for Presbyopia, and the community perception of vision impairment caused by uncorrected Presbyopia. For planning purposes, the data were extrapolated for the futureusingpopulationprojectionsextractedfromtheInternational Data Base of the US Census Bureau. Results:Itisestimatedthattherewere1.04billionpeople globally with Presbyopia in 2005, 517 million of whom hadnospectaclesorinadequatespectacles.Ofthese,410 millionwerepreventedfromperformingneartasksinthe way they required. Vision impairment from uncorrected Presbyopia predominantly exists (94%) in the developing world. Conclusions: Uncorrected Presbyopia causes widespread,avoidablevisionimpairmentthroughouttheworld. Alleviation of this problem requires a substantial increase in the number of personnel trained to deliver appropriate eyecaretogetherwiththeestablishmentofsustainable,affordable spectacle delivery systems in developing countries. In addition, given that people with Presbyopia are at higher risk for permanently sight-threatening conditions suchasglaucomaanddiabeticeyedisease,primaryeyecare should include refraction services as well as detection and appropriate referral for these and other such conditions.

  • global vision impairment due to uncorrected Presbyopia
    Archives of Ophthalmology, 2008
    Co-Authors: Brien A. Holden, Timothy R Fricke, Eric B Papas, Anthea Burnett, Reg Wong, Gerhard Schlenther, Sonja Cronjé, Kovin Naidoo, May S Ho
    Abstract:

    Objectives To evaluate the personal and community burdens of uncorrected Presbyopia. Methods We used multiple population-based surveys to estimate the global Presbyopia prevalence, the spectacle coverage rate for Presbyopia, and the community perception of vision impairment caused by uncorrected Presbyopia. For planning purposes, the data were extrapolated for the future using population projections extracted from the International Data Base of the US Census Bureau. Results It is estimated that there were 1.04 billion people globally with Presbyopia in 2005, 517 million of whom had no spectacles or inadequate spectacles. Of these, 410 million were prevented from performing near tasks in the way they required. Vision impairment from uncorrected Presbyopia predominantly exists (94%) in the developing world. Conclusions Uncorrected Presbyopia causes widespread, avoidable vision impairment throughout the world. Alleviation of this problem requires a substantial increase in the number of personnel trained to deliver appropriate eye care together with the establishment of sustainable, affordable spectacle delivery systems in developing countries. In addition, given that people with Presbyopia are at higher risk for permanently sight-threatening conditions such as glaucoma and diabetic eye disease, primary eye care should include refraction services as well as detection and appropriate referral for these and other such conditions.