title: [The KAMRA™ inlay : A realistic approach?]
abstract: OBJECTIVE
  The KAMRA™ inlay (AcuFocus, Irvine, California, USA) is an additional option for correcting presbyopia that has been used for many years in refractive surgery. Our objective is to report our three-month postoperative results of KAMRA™ inlay implantation in terms of near, intermediate and distance vision.
  
  
  METHODS
  All 24 patients (average age 54.1 ± 6.0 years) were treated with the KAMRA™ inlay in the non-dominant eye (75 % in the left eye) by the same surgeon (MEH). The KAMRA™ inlay was implanted under a 200 µm-thick femtosecond laser-assisted LASIK flap in 2 emmetropic presbyopic patients, 13 hyperopic presbyopic patients and 9 myopic presbyopic patients, without ocular pathologies. The uncorrected distance, intermediate, and near vision were assessed. The central corneal thickness (CCT), endothelial cell density (ECD) and visual field were assessed both pre- and post-operatively. In addition, patients were asked to complete a patient satisfaction questionnaire. Follow-ups were carried out one day, one week, and 1, 3, 6, 9 and 12 months postoperatively.
  
  
  RESULTS
  After three months, all 24 eyes revealed an increase in the mean uncorrected distant visual acuity in the non-dominant eye from 0.4 ± 0.2 to 0.9 ± 0.1, an increase in the mean uncorrected intermediate visual acuity (logMAR, Jaeger 75 cm) from 0.6 ± 0.3 (J 11) to 0.0 ± 0.0 (J 1) and an increase in the mean uncorrected near visual acuity (logMAR, Jaeger 45 cm) from 0.6 ± 0.2 (J 9) to 0.0 ± 0.0 (J 1) monocularly. The visual acuity did not change over the time. The CCT and ECD remained unchanged compared with the findings before surgery. Subjectively, the questionnaire showed high patient satisfaction.
  
  
  CONCLUSIONS
  Femtosecond laser-assisted KAMRA™ inlay implantation can be used in post-LASIK emmetropic patients and patients with a monofocal intraocular lens. It can also be combined with LASIK (for ametropic patients). The potential reversibility, low impairment of psychophysical investigations and the high degree of patient satisfaction makes this novel technique designed to increase depth of focus a reliable method for the surgical correction of presbyopia. Patient selection and centration of the KAMRA™ inlay is crucial.
authors.affiliation: Klinik für Augenheilkunde, Universitätsklinikum des Saarlandes, UKS, Kirrberger Straße 100, Gebäude 22, 66424, Homburg/Saar, Deutschland. melhusseiny@hotmail.com.
authors.forename: M
authors.initials: M
authors.lastname: El-Husseiny
authors.affiliation: Klinik für Augenheilkunde, Universitätsklinikum des Saarlandes, UKS, Kirrberger Straße 100, Gebäude 22, 66424, Homburg/Saar, Deutschland.
authors.forename: L
authors.initials: L
authors.lastname: Daas
authors.affiliation: Klinik für Augenheilkunde, Universitätsklinikum des Saarlandes, UKS, Kirrberger Straße 100, Gebäude 22, 66424, Homburg/Saar, Deutschland.
authors.forename: A
authors.initials: A
authors.lastname: Viestenz
authors.affiliation: Experimentelle Ophthalmologie, Universität des Saarlandes, Homburg/Saar, Deutschland.
authors.forename: A
authors.initials: A
authors.lastname: Langenbucher
authors.affiliation: Klinik für Augenheilkunde, Universitätsklinikum des Saarlandes, UKS, Kirrberger Straße 100, Gebäude 22, 66424, Homburg/Saar, Deutschland.
authors.forename: B
authors.initials: B
authors.lastname: Seitz
mesh_terms: D003315:Cornea / Q000601:surgery*; D019544:Equipment Failure Analysis; D005260:Female; D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011305:Presbyopia / Q000175:diagnosis* / Q000628:therapy*; D019736:Prostheses and Implants; D011474:Prosthesis Design; D019919:Prosthesis Implantation / Q000379:methods*; D016896:Treatment Outcome; D014792:Visual Acuity
keywords: AcuTarget™; Femtosecond laser; KAMRA™ inlay; Micro-monovision; Presbyopia correction