To study the safety and efficacy of corneal reshaping and small-aperture inlays and compare the clinical results.

From February 2014 to November 2014, 22 corneal reshaping inlays were inserted at Asan Medical Center and from October 2012 to March 2013, 26 small-aperture inlay surgeries were performed: 6 eyes at Asan Medical Center and 20 eyes at Samsung Medical Center. The preoperative and postoperative parameters were reviewed retrospectively and included monocular uncorrected distance visual acuity (UDVA; log MAR), uncorrected near visual acuity (UNVA; log MAR), refraction and corneal curvature based on automated refractor keratometry, reading distance and patient satisfaction.

In the hydrogel inlay group, preoperative mean monocular UNVA was 0.83 ± 0.05 and monocular UDVA 0.07 ± 0.03. At 6 months, mean monocular UNVA was 0.23 ± 0.05 and UDVA 0.05 ± 0.02. The most preferred mean reading distance in the hydrogel inlay group was 39.38 ± 3.18 cm. In the small-aperture inlay group, preoperative mean monocular UNVA was 0.4 ± 0.06 and monocular uncorrected visual acuity 0.27 ± 0.04. At 6 months, mean monocular UNVA was 0.11 ± 0.02 and UDVA 0.09 ± 0.05 and the most preferred mean reading distance was 44.23 ± 5.17 cm. Although 85% of patients in the corneal reshaping inlay group were satisfied or very satisfied, only 20% of patients in the small-aperture inlay group were satisfied.

Both inlays are considered good options for correcting presbyopia. However, postoperative satisfaction score was higher and less glare symptoms were reported in the hydrogel inlay group.