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Jorge L. Alió, MD, PhD; M. Emilia Mulet, MD, PhD; Luis F. Zapata, MD; M. Teresa Vidal, MD, PhD; Victoria De Rojas, MD, PhD; Jaime Javaloy, MD, PhD

Arch Ophthalmol. 2004;122:1441-1446.

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

Design  Prospective observational case series.

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

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

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

Results  Of 11 implanted eyes, 5 showed diffuse perilenticular opacity of varying intensity that was unresponsive to steroid use following intracorneal inlay implantation. All patients had moderate to severe loss of best-corrected visual acuity. The inlays showed deposits at the edge and on the surface. Confocal microscopy in all eyes produced images compatible with the confocal morphologic features of epithelial cells. Explantation of inlays was performed in 5 eyes. The histopathologic study showed the presence of epithelial cells, and microbiological analysis and cultures were negative for bacteria, fungi, and mycobacteria.

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

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

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