Speaker shares pearls on KAMRA corneal inlays

DENVER – Sondra Black, OD, shared her experience with the AcuFocus KAMRA corneal inlays as both eye care provider and patient at the Optometric Council on Refractive Technology symposium, held here during the American Academy of Optometry meeting.

According to Black, the technology, which is already available in Canada, will potentially be available in the U.S. in the spring of 2015.

"The increased depth of focus maintains the distance vision while giving the patient the intermediate and near," she said. "You actually have this increased depth of focus, this range of vision all the way through."

Black, director of clinical services at Crystal Clear Vision, said that after some trial and error, they are just performing pocket procedures. These procedures allow for faster visual recovery, less dry eye, a more stable cornea and the ability to place the inlay deeper.

Additionally, their procedure steps have evolved to begin with LASIK, which is followed by pocket creation and then KAMRA insertion at 1 week to 1 month or when stable.

They have learned that there may be some patient sensitivity to 100-micron decentrations. Black also said that decentrations that are superior and temporal are less well tolerated and suggested that placement on the visual axis is ideal.

Black also emphasized the importance of the drop regimen. Preoperatively, all patients are now being put on Restasis (cyclosporine ophthalmic emulsion 0.05%, Allergan), she said. Postoperatively, patients use Pred Forte (prednisolone acetate, Allergan), then FML (fluorometholone, Allergan) or Lotemax (loteprednol, Bausch + Lomb). Patients will be on a steroid regimen for about 9 months.

Check patients beforehand for mild lens changes and impact on vision preoperatively and check for edema afterwards, Black suggested.

She lauded the AcuTarget HD (AcuFocus), which allows practitioners to verify centration postoperatively and measure tear film.

Black has found that patients can return to most activities the next day, but will need to wait 1 to 3 months for clarity of vision. Additionally patients' vision may fluctuate for the first few months, and magnification or light may still be needed.

Black also has the experience of having the inlay herself after undergoing the procedure 1.5 years ago and recommended the procedure to attendees.

"When this comes out, you really should get someone in your center, if not yourself, to have this done if you're presbyopic," she said. "It really makes a difference when you're talking to a patient to have gone through the experience and have gone through the longer, slower healing and be able to commiserate with the patients and fully educate them on what to expect at the end."

Black explained that it took her about 6 weeks to "get out of the fog." – by Chelsea Frajerman

Disclosure: Black has no relevant financial disclosures.