Confocal microscopy of corneas with an intracorneal lens for hyperopia

PURPOSE: We evaluated short-term results and confocal microscopic corneal changes following intracorneal lens implantation. METHODS: In six eyes of three patients with hyperopia between +3.00 and +6.00 diopters (D), an intrastromal hydrogel lens (Permavision, Anamed, Anaheim, Calif) was implanted. Mean baseline hyperopia was +3.90 D. Manifest refraction, uncorrected visual acuity, and spectacle-corrected visual acuity were evaluated. We also performed confocal real-time microscopy with a water immersion objective. Corneal optical sections were recorded and reviewed frame by frame. Examinations were done at months 3, 6, and 12 after intracorneal lens implantation. RESULTS: After surgery, the spherical equivalent refraction was within +0.50 D in 83% (five of six eyes) at 3 months and 100% (six eyes) at 6 and 12 months. Uncorrected visual acuity (UCVA) at 3 months was within 20/40 or better in 67% (four eyes) and in 100% (six eyes) at 6 and 12 months; no eyes had 20/20 or better UCVA at 3 and 6 months. One eye (17%) had 20/20 or better UCVA at 12 months. On confocal microscopy, one eye had an amorphous deposit adjacent to the lens and presumed fibroblastic activity in the same stromal area at 6 months, which was non-progressive up to 12 months. CONCLUSION: Intracorneal lenses may be a treatment option for correction of spherical hyperopia. Predictability must be improved but results in these six eyes were stable up to 1 year. Confocal miscroscopy confirmed biocompatibility and showed no abnormal changes, except two spots of hypercellularity in one eye.