Eyeworld

EW FEATURE 80 Intracorneal inlays • March 2016 with a contact lens are the ones who I consider for this option," he said. Comparing alternatives Dr. Tamayo pointed out that the in- lay can offer a patient more distance than monovision alone can. "Real monovision implies a complete loss of distance vision in the non-domi- nant eye for gain in near," Dr. Tamayo said, adding that with inlays, the loss of distance vision pinhole can be used to help demon- strate what a patient's distance and near vision will be like, he ex- plained. In Dr. Binder's view, corneal inlays offer perks over refractive lens exchange with a multifocal IOL. "The main difference would be the quality of the vision in terms of glare, halos, and dysphotopsia risks," he said, adding that the crispness of the vision at different distances is also a factor. Dr. Binder finds that while multifocal IOLs give good quality distance vision, the near or intermediate vision can be variable and might not be as good compared to an inlay's. This can be compounded by the fact that the adverse optical side effects at night can sometimes be worse with mul- tifocals. While there can be some optical issues with inlays, Dr. Binder said that published literature shows that patients don't report the optical side effects as much as they do with multifocal lenses. "Also, a big advantage with inlays is if you put a multifocal lens in and the patient doesn't like it or it's the wrong power, you're stuck with either doing surgery over that lens or more commonly the lens is exchanged," Dr. Binder said, adding that if patients don't like the inlay, it's simple to remove and doesn't have the risk of going inside the eye. "On average, patients get less than 1 D of accommodation with some of the accommodative lenses," Dr. Binder said. "If the patients don't like the intraocular lens for whatever reason, you're talking surgery— that's a big disadvantage." Going forward, Dr. Binder ex- pects the inlays to continue to make inroads in the U.S. as these wind their way through the FDA approval process. "I think the Raindrop is going to come next—I think it's about 2 years away from submis- sion," Dr. Binder said. Meanwhile, the Flexivue remains behind in the approval process, and the ICOLENS doesn't have any FDA studies ongoing. "It's a European company so I think they're going to stick to European sites," he said. EW Editors' note: Dr. Binder and Dr. Durrie have financial interests with AcuFocus. Dr. Tamayo has financial interests with Abbott Medical Optics (Abbott Medical Optics) and Presbia. Contact information Binder: garrett23@aol.com Durrie: ddurrie@durrievision.com Tamayo: gtvotmy@telecorp.net The FEMTO LDV Z8 is CE marked and FDA cleared for the use in the United States. For other countries, availability may be restricted due to regulatory requirements; please contact Ziemer for details. It's Time to make a Move The FEMTO LDV Z8 is now also available in the United States and Canada! www.femtoldv.com Augencentrum Zytglogge, Dr. Baumann, Berne, Switzerland Visit us at ASCRS 2016 in booth 2917. Presbyopia continued from page 79 is less than with monovision. With inlays, this is between 10 and 25%, whereas with monovision, which puts the patient at about –2 D in the non-dominant eye, there is more than a 50% loss of distance vision. "I think that this form of modified monovision (with the inlay) is far better than the monovision that we used to do in the past," Dr. Tamayo said. Dr. Binder concurs that in- lays are for those who don't want the loss of distance acuity. This is well-suited for those who want to be able to see up close but who still need to be able to see pretty well at distance, he noted. For instance, a plumber might benefit more from the inlay approach than a pharma- cist. To help determine if a patient might benefit from the KAMRA, a

• Cover