Eyeworld

EW REFRACTIVE 96 October 2017 to the nearest half-millimeter. Un- corrected visual acuities at distance (UCDVA) and near (UCNVA) were measured in ETDRS letters. Visual symptoms of glare, halos, and night vision were rated by subjects from 0 (none) to 7 (very severe). Photopic and mesopic data sets were each divided into two groups during anal- ysis based on pupil diameter: greater than average (group 1) and less than or equal to average (group 2). Results: Mean photopic and mesopic pupils were 4.4 ± 0.88 mm and 5.9 ± 0.93 mm. UCDVA for photopic pupil size in groups 1 and 2 was 49.8 ± 4.8 and 50.9 ± 4.3 letters, respectively, and UCNVA was 41.0 ± 7.1 and 42.2 ± 8.1 letters, with no between-group differences. For mesopic pupil in groups 1 and 2, the mean severity of halos was 1.1 ± 1.4 and 0.83 ± 1.5, glare was 0.92 ± 1.3 and 0.64 ± 1.3, night vision was 0.87 ± 1.3 and 0.99 ± 1.6, and the between-group differences were not statistically significant. Conclusion: Pupil size has none to minimal impact on visual acuity and visual symptoms in the eye implant- ed with the small-aperture corneal inlay. Dr. Hofmeister: This study looked at patient reports of visual symptoms and how those symptoms related to pupil size after implantation of another presbyopia-correcting corneal inlay, the KAMRA Inlay (AcuFocus, Irvine, California). Dr. Schallhorn and his colleagues did groundbreaking work back in 2003 to dispel the myth that LASIK patients with large pupils pre- operatively were at higher risk of visual disturbances such as glare and halos after surgery. 1 He has once again shown that pupil size is not a predictive factor of postoperative visual symptoms, this time after small aperture corneal inlays. This information will be extremely helpful in guiding surgeons in their LASIK and a transparent shape- changing corneal inlay with mitomycin-C Julian Theng, FRCOphth Purpose: To evaluate the safety and efficacy of concurrent LASIK and Raindrop Near Vision Inlay (ReVi- sion Optics, Lake Forest, California) implantation with the application of MMC at 0.02%. Methods: Femtosecond LASIK was performed on patients' non-dom- Elizabeth Hofmeister, MD, highlighted the best refractive papers at the "Best of ASCRS" session at the 2017 ASCRS•ASOA Symposium & Congress. The papers were chosen from the Best Paper of Session winners. Here are the abstracts from the studies, with Dr. Hofmeister's comments regarding each selection. Eric Donnenfeld, MD, and Ronald Yeoh, MD, moderated the session, with panel- ists Reay Brown, MD, Clara Chan, MD, Boris Malyugin, MD, PhD, Kevin Miller, MD, and Vance Thompson, MD. Best of ASCRS: inant eye to achieve a +0.75 D refraction. MMC 0.02% was applied to the stromal bed and the flap's stromal surface for 15 seconds. The Raindrop Near Vision Inlay was then placed onto a dry corneal stromal bed. Post-surgery evaluation includ- ed monocular safety measurements: best corrected visual acuities (BCVA), endothelial cell counts (ECC), anterior ocular health and efficacy measurements: UCVA at 6 m and 30/40/50 cm, and MRSE. Results: Twenty-three eyes of 23 pa- tients with a mean age of 47 (range 38–56) and mean reading addition of 1.45 D (range 0–2.25 D) were studied. At 3 months, mean UCNVA was 0.6 at 50 cm, 0.65 at 40 cm, and 0.68 at 30 cm. Mean distance UCVA was 0.71 (range 0.5–1.0), and mean BCVA was 0.91 (range 0.5–1.0). Average change in ECC in the inlay eye was not statistically different (preop: 2745 vs. 3M: 2692, p=0.76). Majority of subjects were clear with no central corneal haze; one subject developed mild corneal haze that resolved with a second round of steroids. Conclusion: The use of MMC seems to be compatible with the Raindrop Near Vision Inlay, showing good ef- ficacy and low incidences of corneal haze. Dr. Hofmeister: Presbyopia-correcting corneal inlays are among the newest surgical options for correcting presby- opia. The Raindrop Near Vision Inlay received FDA approval in September 2016, so U.S. surgeons who were not involved in the clinical trials are less familiar with some of the postoperative issues that can arise. I was interested to learn that intraoperative use of mito- mycin-C 0.02% for 15 seconds reduced the incidence of corneal haze following implantation of the device. Pupil size effect on visual performance with a small- aperture corneal inlay Steven Schallhorn, MD Purpose: Evaluation of the effect of photopic and mesopic pupil size on visual acuity and visual symptoms in emmetropic presbyopes after implantation of a small-aperture cor- neal inlay in the non-dominant eye for the treatment of presbyopia. Methods: 154 subjects' pupil sizes were measured using a pupilometer

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