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    Was 2015 the year of inlays, FLACS, or something else?

    Presbyopic treatments at forefront—led by the first U.S. approval of a corneal inlay

    While 2015 may not have been the year for ground-breaking introductions or trials in the field of refractive surgery, plenty of improvements have kept the procedure an evolving process, Ophthalmology Times editorial advisory board members said.

    One of such advances was the FDA approval of a corneal inlay (KAMRA, AcuFocus ), which may be a first in a series of inlay approvals, said Robert K. Maloney, MD, of the Maloney Vision Institute, Los Angeles.

    “[This] is going to be the year we remember as the one in which intracorneal inlays became an alternative for refractive errors or presbyopia correction,” he said.

    Any method, device, or treatment that represents “a dependable and efficacious treatment of presbyopia is of tremendous interest within the field of refractive surgery,” said Peter S. Hersh, MD, of The Cornea and Laser Eye Institute-Hersh Vision Group, Teaneck, NJ, believes the U.S. approval of a corneal inlay is by far the most important occurrence in the refractive field this year.

    Related: Comparing presbyopia treatment options

    Dr. Maloney agreed: “I really am a believer in corneal inlays. They’re a very benign and reversible way to correct refractive errors and presbyopia. That’s the advantage they have over LASIK, particularly when you’re looking at multifocal corrections.”

    Multifocal LASIK can be difficult to reverse if a patient ends up disliking their postoperative vision, and multifocal IOLs are an invasive procedure. But multifocal inlays are very easy to perform and can be removed if the patient does not like the outcomes, Dr. Maloney said.

    “For a particular subset of patients, corneal inlays may be the way to go,” Dr. Hersh said. “For older patients over the age of 60-65 years, we would still be looking at lens extraction and multifocal premium lenses. But for those in the mid-range of presbyopia, the inlays will have an evolving place among the alternatives of LASIK monovision and presbyLASIK.”

    Next: Outcomes of deep pocket inlays

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