Short-term cell death and inflammation after intracorneal inlay implantation in rabbits

J Refract Surg. 2012 Feb;28(2):144-9. doi: 10.3928/1081597X-20111122-02. Epub 2011 Dec 2.


Purpose: To investigate the cell death and inflammatory response to insertion of the KAMRA inlay (AcuFocus Inc) for presbyopia.

Methods: Twenty-four rabbits were included in the study. Each rabbit had pockets generated in both corneas with a femtosecond laser. One eye of each rabbit had an inlay inserted into the pocket and the opposite control eye had the pocket dissected. Eight rabbits were studied at 24 hours, 48 hours, or 6 weeks after surgery. Tissue sections were analyzed with TUNEL assay to detect cell death and immunohistochemistry for CD11b to detect monocytes as a marker of inflammation.

Results: The inlay group had significantly more stromal cell death than the control group at 48 hours after surgery (P=.038). At 24 hours and 6 weeks after surgery, no significant difference was noted in stromal cell death between the inlay and control groups. Significantly more CD11b+ cells were noted in the stroma in the inlay group compared to the control group at 24 and 48 hours after surgery (P=.025 and P=.001, respectively). However, at 6 weeks after surgery, no significant difference in CD11b+ cells was observed between the control and inlay groups (P=.05).

Conclusions: Although an early increase in stromal cell death and inflammation occurred in eyes that underwent femtosecond laser pocket creation and KAMRA inlay insertion compared to a control group with the pocket only, no significant difference was noted between the inlay and control groups in stromal cell death or inflammation at 6 weeks after surgery.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Apoptosis*
  • CD11b Antigen / metabolism
  • Cell Count
  • Corneal Keratocytes / pathology*
  • Corneal Stroma / surgery*
  • Female
  • In Situ Nick-End Labeling
  • Keratitis / etiology*
  • Keratitis / immunology
  • Monocytes / immunology
  • Postoperative Complications*
  • Presbyopia / surgery
  • Prostheses and Implants
  • Prosthesis Implantation*
  • Rabbits


  • CD11b Antigen