Flap Melting Over Corneal Inlay for Hyperopic Correction.

PURPOSE: To report two cases of flap melting over corneal inlays for hyperopic correction several years after implantation.

METHODS: The corneal inlay (+6.00 diopters [D]; PermaVision intracorneal lens; Anamed Inc., Lake Forest, CA) was implanted underneath a LASIK flap in two patients.

RESULTS: Visual acuity and slit-lamp findings of both patients were stable for several years. At 9 years postoperatively, the first patient presented with a sudden loss of corrected distance visual acuity (CDVA) due to partial flap melting over the inlay while the surrounding anterior cornea showed opacification. The inlay was explanted immediately. Three years after explantation, CDVA returned to 1.0. Similarly, the second patient presented 11 years postoperatively with loss of vision, opacification, and partial flap melting. The inlay was explanted. Two years later, CDVA recovered.

CONCLUSIONS: Potentially severe biocompatibility issues of corneal inlays may occur even after several uneventful years. [J Refract Surg. 2018;34(11):775-778.].