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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