November 09, 2012
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Surgeons debate corneal inlays vs. laser surgery for presbyopia correction

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CHICAGO — While one speaker here said that corneal inlays are the preferred method for presbyopia correction, another surgeon noted the efficacy of laser vision correction.

Perspective from Eric D. Donnenfeld, MD

Damien Gatinel, MD, and Gustavo E. Tamayo, MD, participated in a “point/counterpoint” session during Refractive Surgery Subspecialty Day preceding the joint meeting of the American Academy of Ophthalmology and Asia Pacific Academy of Ophthalmology.

“I think inlays are the way to go for presbyopic correction,” Gatinel said.

Gatinel described results obtained with the Kamra corneal inlay (AcuFocus), Raindrop corneal inlay (ReVision Optics) and Flexivue Microlens (Presbia).

“They are reversible and much less invasive than IOL surgery,” he said. “It’s usually unilateral, and the nondominant eye is implanted. You can adjust and recenter when necessary. It’s effective and precise.”

Laser refractive surgery can be used to fine-tune the implanted and nonimplanted eyes, Gatinel said.

“Surgery of the cornea is an excellent option for the correction of presbyopia,” Tamayo said. “We have a very good satisfaction rate.”

LASIK and femtosecond laser-assisted intrastromal surgery are the leading laser presbyopia correction methods, Tamayo said.

Tamayo said that corneal refractive surgery is less invasive than inlays. He also noted that laser surgery should be targeted to younger presbyopes, aged 43 to 56 years. Inlays frequently cause visual symptoms, but they are reversible and removable, he said.

 

Disclosures: Gatinel has received lecture fees from AcuFocus. Tamayo is a consultant for Presbia.