COMMENTARY

Two New Corneal Inlays Increase Options for Presbyopia

Roger F. Steinert, MD

Disclosures

September 26, 2016

A Less Invasive Alternative

Until recently, the go-to options for treating presbyopia were reading glasses, monovision with either a contact lens or laser vision correction, or multifocal intraocular lenses. Today we now have one more arrow in our quiver: the corneal inlay, which offers patients a safe, less invasive, and reversible alternative to laser vision correction and intraocular lenses.

Two corneal inlays are currently on the market with FDA approval, both of which provide presbyopic correction at the level of the cornea, without laser interaction.

The KAMRA™ Inlay (AcuFocus™; Irvine, California) is a dark, donut-shaped device implanted into a pouch-shaped cut made in the cornea by the surgeon. The inlay is inserted into the nondominant eye of the patient, and the aperture allows an increased depth of focus while preserving distance vision by blocking unfocused light rays from entering the eye. There are thousands of microscopic holes in the devices to allow nutrients and oxygen to flow freely.

The Raindrop® Near Vision Inlay (ReVision Optics; Lake Forest, California) is a refractive disk made of 80% water and material that is similar to a soft contact lens. As with the KAMRA Inlay, the surgeon must create a pouch-shaped flap and insert the disk into the nondominant eye of the patient. The Raindrop Near Vision Inlay alters the refractive power of the eye by steepening the cornea, thereby allowing the eye to focus on near objects and print without the need for reading glasses.

In summary, both the KAMRA Inlay and the Raindrop Near Vision Inlay correct for presbyopia at the cornea in a less invasive, safe, and reversible manner without permanently altering the refractive power of the eye. The FDA trials are complete; now the ophthalmology community will decide over the next several years how these devices will play out in the market.

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