Speaker considers corneal inlays ideal for correcting presbyopia

Issue: November 25, 2014

CHICAGO — Corneal inlays are safe for the patient and simple to perform for the surgeon, according to a speaker here.

Perspective from Jay S. Pepose, MD

Because monovision is the preferred method of presbyopia correction in cataract patients, “Why not introduce [the] inlay into the practice?” Gustavo E. Tamayo, MD, asked in a presentation at Refractive Subspecialty Day preceding the American Academy of Ophthalmology meeting.

“Inlays are additive surgery,” he said. “They preserve future options for presbyopia correction, they are completely removable, there is no biomechanical damage, it is an easy surgery, the situation can repeated, and it is satisfactory,” Tamayo said.

According to Tamayo, inlays are the next alternative for ametropic patients.

“We have an enormous market. We have to find an option to treat those patients without glasses,” Tamayo said.

Disclosure: Tamayo is a consultant for Abbott Medical Optics, Cellular Bioengineering and Presbia Corp. He has equity interest in Abbott and receives royalties from Abbott and lecture fees from Avedro.

Perspective

Jay S. Pepose, MD

Dr. Tamayo highlights a number of attractive aspects of four corneal inlays that are at different stages of progression through the FDA regulatory process. Unlike monovision, which results in a substantial loss of uncorrected distance acuity in the nondominant eye and a reduction in stereopsis, corneal inlays implanted monocularly in the nondominant eye achieve an extended range of intermediate and near vision with less impact on distance vision or stereopsis. In emmetropic patients, some of the inlays can be implanted in a stromal pocket, which has less biomechanical impact than a LASIK flap, and being an additive procedure, they are easily removable. The inlays can be combined with other refractive procedures to achieve a refractive outcome that optimizes their effect. The four inlays utilize different optical strategies, ranging from small aperture optics to induction of changes in corneal curvature to a bifocal pupil-dependent mechanism.

Jay S. Pepose, MD

Pepose Vision Institute

St. Louis

Disclosures: Pepose is a consultant to AcuFocus, Abbott Medical Optics and Bausch + Lomb (Valeant).