1. The authors have no financial interest to disclosure
Clinical Outcomes of Patients With Small-Aperture Corneal Inlay for the Correction of Presbyopia
Randall Ulate, MD (Presenting Author); Noa Avni-Zauberman, MD, MHA; Yakov Goldich, MD; Clara C. Chan, MD, FRCSC; Neera Singal, MD, FRCSC; Mauricio A. Perez, MD; David S. Rootman, MD, FRCSC
The authors have no financial interest to disclosure

2. Purpose
To report the results, safety, efficacy and complications of a small aperture corneal inlay (KAMRA, AcuFocus Inc) to improve near and intermediate vision in emmetropic, hyperopic or myopic presbyopes.
Methods
Design: Retrospective, nonrandomized, consecutive case series.
The corneal inlay was implanted in the non-dominant eye of emmetropic patients, or those undergoing bilateral laser vision correction. Refraction, uncorrected near (UCNVA), intermediate (UCIVA), and distance (UCDVA) visual acuities; best corrected distance visual acuity (BCDVA), subjective patient satisfaction and symptoms, and operative and postoperative complications were evaluated.

3. Results
The study enrolled 69 eyes of 69 patients with a mean age of years, SD: In the treated eyes, 26 were emmetropic (38%), 28 were myopic (40%) and 15 were hyperopic (22%), these two last groups were treated with LASIK, aiming for a postoperative refraction between to 0. The average postoperative follow up period was 7.7 months, SD: 4.7. The mean logMAR uncorrected distance visual acuity in the eye with the inlay improved from an average of 0.51 preoperative to 0.20 in the last postoperative evaluation (Decimal: from 0.56 to 0.68), P= The Spherical equivalent decreased from to , P: The mean Jaeger uncorrected near visual acuity improved from 7.19 to 1.42, P <0.001, and the intermediate visual acuity improved from 7.63 to 1.67, P < eyes of 69 (24.5%) required a surgical re-intervention, 10 eyes (14.5%) were treated with LASER enhancement to correct residual refractive errors, 4 with residual myopia and 6 with residual hyperopia , 4 eyes (5.7%) needed reposition of the implant and 3 eyes (4.3%) required inlay explantation, due to progressive hyperopia, epithelial ingrowth or intolerable impaired night vision respectively.
58 of 69 patients (85%) were satisfied with the visual results, particularly with their vision without reading glasses.

4. Distance Visual Acuity (Decimal values)
-Eye with the inlay-

5. Uncorrected Near and Intermediate Visual Acuity (Jaeger Values)
-Eye with the inlay-

6. Comparative Chart of Spherical Equivalent Values
-Eye with the inlay-

7. Comparative Chart of Uncorrected Visual Acuity
-Eye with the inlay-

8. Conclusion
The results obtained suggest that implantation of a small-aperture inlay in presbyopic patients, is a clinically safe and effective alternative to improve near and intermediate vision in presbyopic patients, with a minimal effect on distance vision, with a relatively low rate of complications, although a number of interventions were required in many cases to obtain the desired outcome of patient satisfaction and less dependence on reading glasses.