New alloplastic materials are being used as intracorneal inlays to offer predictable and safe refractive surgical correction of presbyopia and low hyperopia. The major problem with such inlays is the wound-healing response following their insertion; however, they can easily be removed.
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.
The FDA has approved AcuFocus’ corneal inlay product (KAMRA inlay.) The device is indicated to improve near vision by extending depth of focus in patients with presbyopia who have emmetropic refractions (+0.50 to –0.75 D).
The optimal time of implantation of a corneal inlay (Kamra, AcuFocus) to correct presbyopia in ametropic presbyopic patients seems to be 1 week after traditional LASIK in a planned two-stage KAMRA procedure.
Dysfunctional lens replacement may be a better option in certain cases for patients with dysfunctional lens syndrome who initially seek LASIK correction. With the availability of advanced diagnostic equipment, surgeons can now identify candidates and recommend this solution.
Following deliberations, the FDA’s ophthalmic devices advisory panel has determined that the benefits of AcuFocus’ Kamra inlay outweigh the risks for patients suffering vision loss as a result of presbyopia.