The Optics and Vision of KAMRA vs. Raindrop...
Transcript of The Optics and Vision of KAMRA vs. Raindrop...
The Optics and Vision of
KAMRA vs. Raindrop Inlays
R. Luke Rebenitsch, MD
Refractive Surgeon
Wavefront Congress
February 24, 2017
Disclosures
• Acufocus
• Ziemer
• Staar Surgical
• Wavefront Congress
• Refractive Surgery Alliance
Outline
1) Optics of each inlay
2) IDE results
3) Personal results and case reports
4) Current considerations
KAMRA Inlay
• PVDF inlay with central hole and without refractive power
• Increased depth of focus through small aperture optics
• Location: 200-250μcorneal pocket
Raindrop Inlay
• Transparent hydrogel inlay without refractive power
• Increased depth of focus through profocal(hyperprolate) cornea
• Location: Underneath 30% corneal thickness flap
KAMRA Small Aperture Optics
Raindrop Profocal Cornea
through Epithelial Remodeling
Raindrop Refractive Inlay Effect
• Steinert RF. Range of refractive independence and mechanism of action of a corneal shape-changing hydrogel inlay: results and theory. J Cataract Refract Surg. 2015 Aug;41(8):1568-79
Results from the KAMRA US IDE
• An average 3 line gain at 12 months was achieved and sustained over the duration of the study
• Achieved results remain stable over the 36 month follow-up
Effect of Refraction on KAMRA
Visual Outcomes
Raindrop Course and Stability
Average Change in Uncorrected
Acuity at 24M with Raindrop
Personal KAMRA Experience
over the first ~100 KAMRA
inlays
Raindrop Case Report
• 50 Y/O desiring computer and phone vision without loss of distance vision
• Pre-op MRx
– OD: +0.25 +0.50 X 020 = 20/20
– OS (Dominant): +0.75 Sph = 20/20• UNVA: 20/80
• Post-Op OD Monocular Visions
– Monocular UDVA = 20/12
– Monocular UNVA: 20/25
SA: 0.174 SA: -0.172SA: -0.617
Pre-OP Week 1 Month 3
KAMRA Case Report
• 49 Y/O with desired improved computer and reading vision without loss of distance
• Pre-op MRx
– OD (dominant): -0.25 Sph =20/20
– OS: Pl=20/20• UNVA: 20:80
• Post-OP LASIK OS and KAMRA OS
– Monocular UDVA: 20/25
– Monocular UNVA: 20/20
Current Considerations
KAMRA
• Combined procedures to achieve ideal refraction of -0.75
• Centration - ↑Importance
• Deeper Pockets
• Role of MMC?
Raindrop
• Combined procedures to achieve ideal refraction of ~+0.25
• Centration – ↓Importance?
• Pocket versus Flap
• Role of MMC?
Conclusion
• Both corneal inlays achieve excellent and similar uncorrected near vision with minimal loss of uncorrected distance vision
• Attention to detail and understanding of the optics of each inlay is necessary to achieve ideal results
Thank you