Bilateral implantation of a supplementary intraocular pinhole

To evaluate the safety and efficacy of bilateral implantation of a supplementary small-aperture device to treat irregular corneal astigmatism.

Private practice.

Retrospective consecutive case series.

Patients with bilateral irregular corneal astigmatism secondary to multiple causes and consented for implantation of the XtraFocus intraocular pinhole (IOPH) were enrolled. The mean follow-up was 27 months (range 5 to 66 months). Patients were assessed in their scheduled follow-up visits and monocular and binocular uncorrected and corrected distance and near visual acuities were recorded. Assessment of darkening vision complaints was also performed after implantation in the first eye and repeated after second-eye surgery.

Thirty-two eyes of 16 patients were analyzed. The mean monocular and binocular uncorrected distance visual acuities improved from logMAR 1.091 ± 0.208 and 1.078 ± 0.259 preoperatively to 0.342 ± 0.091 (P < .001) and 0.342 ± 0.147 (P = .001) 1 year postoperatively. Three patients were excluded because of darkening vision complaints after surgery in the first eye. No major complications were noted after implantation of the IOPH.

Bilateral implantation of the XtraFocus IOPH is a safe technique in a selected group of patients. There was improvement in visual acuity sustained over the analyzed period. Postoperative darkening vision complaints vary between individuals and can limit the application of this approach in certain patients.