Preloaded refractive-addition corneal inlay to compensate for presbyopia implanted using a femtosecond laser: one-year visual outcomes and safety

J Cataract Refract Surg. 2014 Aug;40(8):1341-8. doi: 10.1016/j.jcrs.2013.11.047.


Purpose: To report the results of the Icolens corneal inlay 12 months after implantation.

Setting: Department of Refractive Surgery, Mater Private Hospital, Dublin, Ireland.

Design: Prospective case series.

Methods: The inlay was implanted in the nondominant eye of emmetropic patients through a femtosecond laser-created corneal pocket.

Results: The mean uncorrected near visual acuity (UNVA) in the surgical eye (n = 52) improved from N18/N24 preoperatively to N8 postoperatively (P = .000); all patients had a UNVA of N16 or better and 9 (17%), of N5 or better. The uncorrected distance visual acuity (UDVA) in the surgical eye increased from 0.05 logMAR ± 0.12 (SD) preoperatively to 0.22 ± 0.15 logMAR postoperatively (P = .000). There was a mean loss of 1.67 ± 1.77 lines of UDVA (P = .000). Binocularly, there was a mean gain of 0.48 ± 1.16 lines of UDVA postoperatively (P = .000), with 22 patients (42%) gaining more than 1 line. The mean loss of corrected distance visual acuity postoperatively was 1.78 ± 1.04 lines (P = .000). There was no significant change in corneal topography or endothelial cell count. On the satisfaction survey, 90% of patients reported being happy ("yes" or "rather yes") with the overall procedure in general. Eleven implants were explanted because of minimal improvement in UNVA. No significant adverse events were reported throughout the study.

Conclusion: The new refractive-addition corneal inlay effectively corrected presbyopia in emmetropic presbyopic patients.

Financial disclosure: No author has a financial or proprietary interest in any material or method mentioned.

MeSH terms

  • Aged
  • Biocompatible Materials
  • Contrast Sensitivity / physiology
  • Corneal Stroma / surgery*
  • Corneal Topography
  • Emmetropia
  • Female
  • Humans
  • Male
  • Middle Aged
  • Patient Satisfaction
  • Polymethacrylic Acids*
  • Presbyopia / physiopathology
  • Presbyopia / surgery*
  • Prospective Studies
  • Prostheses and Implants*
  • Prosthesis Implantation*
  • Refraction, Ocular / physiology
  • Surgical Flaps
  • Visual Acuity / physiology*


  • Biocompatible Materials
  • Polymethacrylic Acids
  • methylmethacrylate-methacrylic acid copolymer