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Alternatives to Using Cheaters

Alternatives to Using Cheaters

Created on: Tuesday, September 19, 2017
Author: Eye Surgeon Associates

New FDA approved treatment for reading vision.

By: Dr. Carlton Fenzl

If you’re over 40, you’ve probably noticed your near vision isn’t as sharp as it used to be. Reading fine print may require you to wear reading glasses or bifocals. For those who dislike wearing cheaters, there are several techniques to treat presbyopia.

Current options

The first is monovision that corrects one eye for distance and the second eye for near vision. This can be done using contact lenses, having LASIK or cataract surgery. It is effective and well tolerated in many people. However, it does have some downsides including decreased depth perception, as well as nighttime glare. 

Another option is a multifocal contact lens. These lenses have multiple focal points in each lens allowing people to see distance and near at the same time. Multifocal lenses have similar downsides to monovision.

Newly approved options

The newest treatment for presbyopia is the corneal inlay. This is an ultra thin device that is implanted within the cornea during surgery. The first one to be FDA approved in the United States is the Kamra inlay (AcuFocus, Irvine, CA, USA). The FDA approval was based on results from a five-year clinical study of 508 patients who experienced an average improvement in uncorrected near visual acuity of 20/40 or better during a 12-month follow-up. 

This new device takes advantage of the pinhole effect. A pocket is created using laser technology in the non-dominant eye. A pinhole-shaped implant is then inserted into the pocket. This allows the patient to see distance and near using the non-dominant eye while maintaining distance vision in the dominant eye.

The Raindrop corneal inlay (ReVision Optics, Lake Forest, CA, USA) is the second inlay to become FDA approved. It is a clear thin disc that is implanted under a LASIK flap. By changing the central curvature of the cornea in the non-dominant eye, one is able to see distance and near. As with Kamra, the dominant eye retains good distance vision.

Similar to LASIK, not everyone will be a good candidate. Your prescription, dry eyes, and the overall health of your eyes are a few of the screening criteria. This is surgery and like any surgery, the risks and benefits should be reviewed. One of the advantages to these new inlays is that they can be removed, however, performing surgery again has risks. 

Both procedures are fairly new and initial outcomes look positive. ESA does not offer these new inlays yet, but will continue to monitor these exciting new changes in refractive surgery. 

The material contained in this article is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health care provider.


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