Cornea Inlay for Presbyopia NO WAY

[JohnHaganMD]

I have recently attended several meetings in which there was frank discussion of the newly FDA approved cornea inlays for the correction of presbyopia. (loss of ability to read at near due to age, for most people becomes symptomatic in early to mid-40's.)

The consensus of some of the most experienced and well known corneal refractive surgeons in the world...............THUMBS DOWN.  Would not want in their eyes. The cornea has never been a good receptacle for foreign material.  High likelihood a very high percentage of these will need to be removed within 5 years.  When eye surgeons say they would not want something in their own eye why would you want it in yours? The most enthusiastic surgeons? Yes you guessed it the ones paid by the company to test the product.

I have no financial interest in any company that would me "biased" one way or another. I spend a lot of time dealing with a defective intraocular lens (IOLAB AZAR 91-Z) and know that ill conceived products can still pass clinical testing.

JCH MD

[JohnHaganMD]

Glad you mentioned the name. yes the Kamra Corneal Inlay is that of which I speak. I would totally avoid this product and I believe in 5-10 years many people will rue having it put in their corneas.

JCH MD  

[JohnHaganMD]

No :Worst case it's easily removed with your vision eventually going back to normal overtime.     Is not the worst case. Worst case is cornea gets infected, scarred, irregular corneal astigmatism, vascularized and a lamellar corneal incision or even a full thickness corneal transplant is needed.

JCH MD

[except]

I skimmed the FDA paper on this the other day (http://www.accessdata.fda.gov/cdrh_docs/pdf12/P120023b.pdf) The impression I got about the Kamra was that it's early generation technology that will improve over time. (just look at the raindrop inlay, which will be marketed heavily towards people with monofocal iols)
Worst case it's easily removed with your vision eventually going back to normal overtime.

The main drawback for me would be the lasik like flap thats created before placing the inlay.

[SoftwareDeveloper]

re: "Would not want in their own eyes"

There are some prominent eye surgeons who have *already* had corneal inlays implanted in their own eyes. While I appreciate the doctor's views and the time he takes to try to be of help, I will note that this is a topic that physicians seem to disagree about. His report of what he views as the "consensus" differs from  the reports I've seen from recent conferences, as well as the published data I've seen, and the fact that the Kamra was approved in the first place. I don't know what to make of the controversy, and fortunately since I'm not a candidate for an inlay now I don't need to, I'm just noting the existence of differing viewpoints for others to explore to make up their own mind.

I'll let people search for study data, but  here are some physicians who have had inlays (and I'll also note that the inlay technology has improved the last few years, as has its implantation technique, and that the data I'd seen suggest the Raindrop may be better than the Kamra these surgeons tend to have used. There are likely surgeon testimonials for those as well, I'm just passing along some links I had laying around already):

http://www.businesswire.com/news/home/20110829005369/en/Leading-Ophthalmologists-KAMRA-Inlay-Patients
"Leading Ophthalmologists Become KAMRA Inlay Patients
Doctors discuss benefits of being a patient to a procedure they perform
August 29, 2011 08:00 AM Eastern Daylight Time
Ophthalmologists Robert Rivera, Rick Wolfe and Dean Corbett, MDs all had successful surgery to correct their vision loss, by receiving the KAMRA inlay. "

http://crstodayeurope.com/2014/02/distance-acuity-near-vision-and-my-old-reading-glasses/
"In this “patient,” the Kamra inlay has been rewarding for every aspect of visual function."

http://crstodayeurope.com/2012/03/surgeon-patient
"After having the Kamra corneal inlay (AcuFocus, Inc.) implanted and a LASIK enhancement procedure for my intermediate and distance vision, I can share my experience with patients "

http://crstoday.com/2015/06/personal-experience-with-a-corneal-inlay/
"Personal Experience With a Corneal Inlay"

http://ophthalmologytimes.modernmedicine.com/ophthalmologytimes/content/tags/acufocus-inc/physician-patient-receives-corneal-inlay-his-own-eye?page=full
"Physician-patient receives corneal inlay in his own eye"

http://eyetube.net/series/physician-perspectives/patient-perspective-small-aperture-corneal-inlay/
"In this video, Robert Rivera, MD, of Hoopes Vision Correction Center in Salt Lake City, shares his unique perspective as a patient who received a KAMRA™ small aperture inlay over two years ago. Dr. Rivera reports his satisfaction with getting out of glasses and the immediate impact that had on both his professional and personal interests. "

[JohnHaganMD]

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