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55 EW REFRACTIVE SURGERY August 2015 Best in refractive surgery LASIK and PRK, with excellent high and low contrast visual acuities at 1, 3, and 6 months postop. Evolution of profiles of different corneal parameters in progressive keratoconus David Smadja, MD, and colleagues Purpose: To analyze the evolution profiles of several corneal topo- graphic and tomographic parame- ters in progressive keratoconus and compare to the kinetic of evolution of the gold standard parameter, anterior keratometry. Methods: One hundred and twen- ty-four eyes of 62 patients with mild to severe keratoconus were prospectively enrolled and followed every 3 months during at least 1 year. Fifty-six corneal parameters were measured at each visit using a combined Placido-based and dual Scheimpflug imaging system. Means and percentage of progression (PP) between each visit were calculated for each parameter and compared to the anterior keratometry changes using the Student's t-test. Results: At 1 year, 12% (15/124) of eyes progressed with an increase in anterior keratometry of 1 D or more. Among these eyes, posterior steepest keratometry and vertical coma had a significantly higher percentage of progression (p<0.01) than the anterior keratometry and occurred significantly earlier (p<0.01) than the modifications of the anterior keratometry, with changes noted on average at 6.2, 5.9, and 10.1 months for posterior keratometry, vertical coma, and anterior keratometry, respectively. Pachymetric-related parameters did not show significant changes between the progressive and non-progressive eyes. Conclusion: Modifications of the posterior keratometry and vertical coma occurred significantly earlier than the anterior keratometry in progressive keratoconus eyes. These parameters may be relevant warning signs when monitoring progressive keratoconus. Dr. Hofmeister: I follow many keratoco- nus patients in my cornea practice. Like many cornea surgeons, I eagerly await the FDA approval of corneal collagen crosslinking to halt the progression of keratoconus. Until it is approved, all I can do is urge my patients with progressive keratoconus to seek out one of the U.S. FDA trials on their own. The earlier a progressing cornea is crosslinked, the better, but what are the earliest markers? What I liked about Dr. Smadja's paper is that he identified 2 markers, increasing posterior corneal curvature and increasing coma, which can help me pick out patients who have progressive keratoconus up to 6 months before they show anterior corneal steepening. Non-refractive corneal inlay implantation after cataract surgery: U.S. clinical study experience Ralph Chu, MD (Editors' note: Dr. Chu is a clinical investigator for the Raindrop Near Vision Inlay [ReVision Optics, Lake Forest, Calif.]) Purpose: To assess the feasibility of implanting a hydrogel corneal inlay in patients that previously underwent cataract surgery with IOL implantation as part of the Raindrop Near Vision Inlay U.S. study. Methods: Prospective non-ran- domized multicenter clinical study. Twenty-five (n=25) subjects implant- ed with Raindrop Near Vision Inlay in the non-dominant eye of pseu- dophakic eyes (minimum 3 months after IOL implantation). Visual acu- ities (uncorrected and best distance corrected), quality of life and patient satisfaction at 1, 3, and 6 months are being evaluated. Results: At the time of abstract submission, 6 eyes have been im- planted, with 5 seen at the 1-month follow-up visit. The other 19 sub- jects' eyes will be enrolled and the abstract updated with more compre- hensive data. Uncorrected distance vision at 1 month is 20/32 or better, and uncorrected near is 20/25 or better in all eyes. There are no com- plications at this point. Uncorrected visual acuities (mean, SD), percent- age of patients that are satisfied with their near vision, bright and dim light tasks and safety profile will be reported. Conclusion: Options for surgical correction of presbyopia after cata- ract surgery are limited because this population (as it grows older) has the potential for age-related diseases like increasing rates of retinal/mac- ular diseases and others. Raindrop is a removable corneal inlay, which provides a reversible alternative for this group of patients. Dr. Hofmeister: Dr. Chu's paper inter- ested me because it describes a novel technology to correct presbyopia. These were preliminary results from the U.S. FDA trial, but the device shows promise in improving near vision without sacrificing distance vision or inducing significant visual aberrations. EW Editors' note: Dr. Hofmeister is a cornea, external disease, and refractive surgery specialist stationed at Naval Medical Center San Diego. She has no financial interests related to this article. The views expressed in this article are the author's and do not necessarily re- flect the official policy or position of the Department of the Navy, Department of Defense, or the U.S. Government. Contact information Hofmeister: elizabeth.m.hofmeister.mil@mail.mil View Dr. Hofmeister's presentation at Clinical.EWrePlay.org.

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