Surgical Correction of Presbyopia

Lenticular, Corneal, and Scleral Approaches

Michael Greenwood, MD; Shamik Bafna, MD; Vance Thompson, MD


Int Ophthalmol Clin. 2016;56(3):149-166. 

In This Article

Multifocal Refractive Inlay

The Icolens (Neoptics, Hunenberg, Switzerland) is a 3-mm-diameter multifocal corneal inlay made of a hydrophilic acrylic hydrogel. The central zone has a diameter of 1.8 mm, an edge thickness of 15 μm, and a 150 μm central hole to facilitate nutrient flow. It uses the peripheral zone for near vision correction and a central zone for distance vision. The bifocal design delivers 2 images on the retina simultaneously, similar to multifocal IOLs.

Early results in a study from Baily et al[26] demonstrated a significant improvement in vocational and UNVA with a moderate loss in monocular UDVA, but there was a loss of CDVA, with 40 patients (77%) losing >1 line. Corneal opacity or haze was not seen in any patient who lost lines of CDVA. No patient who lost lines of CDVA said they believed their binocular UDVA was affected; in fact, many said their UDVA was improved. The authors believe that this loss of CDVA was most likely a result of a neuro-optical phenomenon related to the implant. It could also have been caused in part by the difficulty in obtaining an accurate manifest refraction due to the multifocality of the inlay.