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Clinical Sciences
October 2004

Intracorneal Inlay Complicated by Intrastromal Epithelial Opacification

Author Affiliations

From the Corneal and Refractive Surgery Department (Drs Alió,Mulet, Vidal, and Javaloy) and the Cornea Department (Dr Zapata), InstitutoOftalmológico de Alicante, Alicante, Spain; Division of Ophthalmology,Miguel Hernández University, Alicante (Drs Alió, Mulet, andZapata); Department of Ophthalmology, Pontificia Bolivariana University, Medellín,Colombia (Dr Zapata); and Instituto Gallego de Oftalmologia, Universidad deSantiago de Compostela, Santiago de Compostela, Spain (Dr De Rojas). The authorshave no relevant financial interest in this article.

Arch Ophthalmol. 2004;122(10):1441-1446. doi:10.1001/archopht.122.10.1441

Objective  To report epithelial perilenticular opacity as a new complication ofintracorneal inlay implantation for the correction of hyperopia.

Design  Prospective observational case series.

Participants  Eleven eyes of 7 patients underwent intracorneal inlay implantationfor the correction of hyperopia.

Methods  Intracorneal inlays were implanted onto the stromal bed by using a microkeratomecut to create an inferior hinged corneal flap.

Main Outcome Measures  Postoperative complication occurrence of intracorneal perilenticularopacity, microbiological laboratory analysis, histopathological analysis,and confocal microscopy study.

Results  Of 11 implanted eyes, 5 showed diffuse perilenticular opacity of varyingintensity that was unresponsive to steroid use following intracorneal inlayimplantation. All patients had moderate to severe loss of best-corrected visualacuity. The inlays showed deposits at the edge and on the surface. Confocalmicroscopy in all eyes produced images compatible with the confocal morphologicfeatures of epithelial cells. Explantation of inlays was performed in 5 eyes.The histopathologic study showed the presence of epithelial cells, and microbiologicalanalysis and cultures were negative for bacteria, fungi, and mycobacteria.

Conclusion  Epithelial perilenticular opacity is a new and serious complicationin patients with intracorneal inlay implantation for the correction of hyperopia.