What is KAMRA?
Martin L. Fox, MD, FACS
Our eyes have the ability to adjust point of focus from distance to near range through a process known accommodation where the internal focusing lens of the eye changes shape. This shape change allows for the addition of more focusing power allowing for the performance of near visual tasks. As part of the inevitable aging process the eye loses its ability to accommodate for near and we find ourselves needing the aid of reading glasses. The loss of near vision function is referred to as presbyopia and usually sets in anywhere from our early to mid forties with the initial recognition that reading small print is difficult. The loss of near focus progresses to the point that nearly all “up-close” vision will require the use of reading glasses.
Individuals who are near sighted or myopic can have an advantage over others when it comes to the middle age onset of presbyopia. Those that have myopic refractive error have eyes that have an over abundance of optical plus (+) power and as a result they wear prescriptions that have a corresponding minus (-) power to neutralize their inherently over powered eyes. As myopes grow older they too begin to lose the ability to accommodate for near vision, however, because they are near sighted and have eyes with excessive optical plus power they can compensate for the problems at near by simply removing their prescription—that is until they have Laser Vision correction performed. Myopic Lasik or PRK when boiled down to its simplest essence consists of reshaping the cornea to address the optically over powered eye and thus bring distance vision into focus. The effect of Lasik surgery will efficiently clear vision at distance but, as a result of eliminating the myopic refractive error, those treated will lose the ability to compensate for the loss of accommodation by removing the myopic eye glass prescription now eliminated by the laser procedure.
The dream of the majority of those of us who require reading glasses for even the most trivial of near vision tasks is a viable safe solution to correct this ubiquitous visual problem that affects 25% of the world population. This is a dream that has been shared by those of us in the field of refractive surgery as well. Our family of custom laser vision correction procedures has evolved to a point that we can correct distance vision issues with a patient satisfaction rate of over 99%. But the ability to help those who just want to rid themselves of those annoying reading glasses has evaded us for years despite a considerable body of clinical investigation and study.
Up until now the inevitable loss of near vision that happens in our forties could only be addressed with glasses contact lenses or mono-vision solutions with one eye corrected for distance and the other for near. The arrival of FDA approval for KAMRA in April 2015 changed everything. It is the first procedure that can safely eliminate or reduce the need for reading glasses without sacrificing quality distance vision. It is the brainchild of a California company called Acufocus.
KAMRA is a 5-microns thin, 3.8 mm disc made of a biocompatible plastic material used in cataract implant lenses for years. The disc has a small central 1.6 mm opening. When this small aperture is centered over the pupil it delivers a remarkable improvement of the range of vision of the eye by only allowing focused light to enter the eye. This pinhole effect has is often used in photography to allow a clear image in near range without loss of clear focus in the distance. The very same optical principle allows the KAMRA inlay to effectively correct the inability to see at near without sacrificing the clarity of vision in the distance.
The KAMRA Corneal Inlay procedure consists of the gentle placement of the device into a small precise femtosecond laser created pocket in the center of the cornea in a painless 10-minute procedure. Centration of KAMRA is guided by a new technology called Acutarget that identifies exactly where KAMRA needs to be positioned in the corneal lens in order to deliver its optimal effect. Recover from KAMRA inlay surgery is rapid; with most recipients enjoying vastly improved reading vision immediately after surgery. Completion of the entire healing process can take four to six weeks at which time KAMRA patients report excellent vision at all ranges.
One of KAMRA’s greatest features is its safety. The KAMRA procedure is rapid and the immediate results are impressive, however, should an individual decide KAMRA is not for them it can be removed and the effect totally reversed. Following removal, the corneal laser pocket will heal over 7-10 days without any lingering effects.
Frequently Asked Questions about the KAMRA Corneal Inlay
What makes a good KAMRA candidate?
Most Individuals between the ages of 40-60 years of age who are unhappy with having to rely on reading glasses make for good candidates. Key in great KAMRA outcomes is that your uncorrected vision in the distance must be good. However, those wishing KAMRA vision can have their distance vision corrected prior to KAMRA placement with one of our laser vision correction procedures.
How long does the surgery take? Is it painful?
KAMRA surgery is quick and painless with most procedures requiring only 15 minutes to perform.
Is KAMRA placed in both eyes?
No. KAMRA is implanted only in the non-dominant eye. We have dominant and non-dominant eyes just as we have a dominant right or left hand.
Is the KAMRA inlay a mono vision procedure?
No. Unlike mono vision LASIK or contact lenses that can compromise distance vision the KAMRA inlay improves both near and intermediate vision while maintaining normal distance vision.
If I need glasses for both distance and near vision can KAMRA still work for me?
Yes. KAMRA Inlay procedures can be combined with LASIK or PRK for distance vision correction at the same time thus giving you both excellent vision at near, intermediate and distance ranges.
How long does it take to enjoy the full benefits of KAMRA?
Most individual who elect to have KAMRA can expect to see an immediate impact on reading vision. However, the majority of patients will require 4-6 weeks of healing during which time vision can fluctuate.
Will I feel the inlay in my cornea?
No. KAMRA is placed in a corneal pocket at a minimal depth of 250 microns, well below the area of the cornea that sub serves sensation.
Will friends or family be able to see the inlay in my cornea?
The inlay is essentially invisible to external view. One can detect the inlay only if very close and then only if observing from an oblique angle.
Will I need a stronger KAMRA inlay in the future?
No. Unlike reading glasses, the KAMRA does not contain a lens. Instead it works on the same principle used in photographic camera lenses by increasing your depth of focus providing a wider range of vision. This is a feature that will never need adjustment.
Will the KAMRA inlay continue to work 10 years from now?
The KAMRA inlay has been proven to continue to provide stable vision for those that have participated in the clinical trial. Many of those patients have had the inlay for greater than 8 years. It will provide years of uncorrected reading vision.
How will the inlay affect my vision if I develop cataract?
Should a cataract develop it can have an affect on both near and distant acuity unrelated to KAMRA. The cataract can be removed in the usual manner with the inlay in place allowing patients to enjoy its continuing benefits afterwards.
If for any reason I don’t like it can KAMRA be safely removed without affecting my vision?
Yes. KAMRA can be safely removed if necessary returning the cornea to its original state.
Since starting out KAMRA program we have treated over 70 patients. Our results have been very satisfying with over 98% of our patients saying that they would recommend KAMRA to family and friends.