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    New correction option for presbyopes

    Removable corneal inlay a choice for emmetropes

    For the longest time, I felt that to be a true ophthalmic pioneer, it would take finding a cure for the single most heinous of nature’s evolutionary designs—presbyopia! Such a cure would make even the most skeptical of investors on Shark Tank envious.

    At present we are limited with our ability to treat presbyopes. Sure, we have progressives and multifocal contact lenses; however, from a surgical standpoint, monovision corneal refractive surgery is limited, and clear lens extraction is often extreme for emmetropes. There is now another option which can provide a large percentage of these patients with good distance and near vision with the use of Kamra corneal inlay from AcuFocus.


    Inlay for the non-dominant eye

    Kamra is the only FDA-approved refractive inlay designed to be implanted in the non-dominant eye and is removable. This microperforated, opaque inlay increases depth of focus by creating a shield to unfocused light. At 5.0 µm thick, with a central aperture of 1.6 mm and an overall diameter of 3.8 mm, this small inlay casts a large presbyopic shadow. The inlay has over 8, 000 randomized spots that provide for this novel form of presbyopic correction.

    Related: How technology changed optometry's role in cataract comanagement

    As in any early surgical procedure, it is important to understand limitations and who will have the best chances at success. I recall with not such great fondness the excitement that the refractive community had when new lenses or surgical options were first approved. This translated into wanting to provide options for anyone, only to be let down when patients didn’t experience the same success as in clinical trials. At the 2014 Optometric Council on Refractive Technology (OCRT) meeting in Denver, Sondra Black, OD, described the important pre- and postoperative regimens needed for Kamra’s success. In her estimation, when best practices are followed, patients typically achieve J1 to J2 near and 20/20 to 20/25 intermediate in the inlay eye. Our clinic successfully implanted the Kamra in 11 patients, closely mirroring the results that Dr. Black described. Visual acuities at distance and near were markedly improved in these neophyte cases.

    Next: Good candidates for corneal inlay


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