PEARL: PrEsbyopic Allogenic Refractive Lenticule

PEARL is a new presbyopic corneal inlay technique that utilizes a lenticule of suitable thickness obtained from small incision lenticule extraction (SMILE) which is marked and trephined at its center to a diameter of 1mm. It is then implanted in the cornea on the coaxially sighted light reflex under a 120 micron femtosecond cap in the non-dominant eye of a presbyopia patient. The PEARL inlay acts as a shape change inlay by increasing the central radius of curvature, resulting in a central area of hyperprolateness on the cornea which translates to a good improvement in near vision.

The PEARL inlay is made of allogenic material and therefore allows unhindered passage of oxygen and nutrients in the cornea unlike synthetic implants. This ensures stable corneal conditions, decreases risk of corneal necrosis and melt, and provides biocompatibility and good integration into the cornea. It also avoids inflammation related to the insertion of synthetic material into the cornea. Preservation of good uncorrected distance visual acuity is another major advantage of this technique.