This article is more than 5 years old. Information may no longer be current.
It’s a great time to be a presbyope
Click Here to Manage Email Alerts
Just a few years ago, I used to regularly make fun of my more senior friends and colleagues when they donned their reading glasses to see fine print. Now, at age 46, presbyopia doesn’t seem so funny anymore. Thankfully, a number of great technologies promise hope for us oldies. Personally, I love offering patients both the multifocal and accommodating IOLs that are approved but am very excited about newer, better IOL technologies. That is, if the FDA will ever approve them.
More exciting still are the burgeoning technologies for the younger, emmetropic presbyope. Three corneal inlays are nearing approval in the U.S., and each offers promising results so far. The exciting thing about these inlays is they improve near vision in one eye while degrading distance vision much less than traditional monovision.
AcuFocus, first in line with its Kamra inlay, uses small-aperture optics to increase depth of field. It’s effective. It’s now proven reasonably safe, and it allows distance acuity as good as 20/20 while providing J2 near vision. Its one drawback: The Kamra inlay, a dark circle overlying the pupil, is not invisible and can be seen by others who are looking carefully at the eye of someone who has the implant, especially if they look from an oblique angle.
Second in line, an equally promising option for the emmetropic presbyope, is the Raindrop inlay from ReVision Optics. This very thin, hydrogel inlay (the same material that soft contact lenses are made of) is invisible to the eye and provides J1 near vision. Distance vision in the treated eye typically improves to 20/25 a few months after implantation. It’s extremely well-tolerated, and more than 95% of patients in clinical trials are very satisfied with their results.
Presbia makes the third inlay in the lineup. This is an acrylic lens implanted in the cornea. Although we have less data on results with this device, it too promises very acceptable uncorrected near acuity while preserving some degree of distance focus.
With more than a billion emmetropic presbyopes around the world, clearly the opportunity for correcting presbyopia in the younger, emmetropic patient is a huge opportunity for our profession and our industry. I am excited to see these first three products come to market in the U.S. and offer hope to the old and weary, like me.