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EW SHOW DAILY 8 Tuesday, May 10, 2016 ASCRS News Today by Lauren Lipuma EyeWorld Contributing Writer ed, 75% were satisfied with their overall vision after 3 months, and 88% of patients can perform most near tasks in good light without W ith the approval of the KAMRA corneal inlay (AcuFocus, Irvine, California) and the Raindrop near vision inlay (ReVision Optics, Lake Forest, California) in clinical trials, inlays are poised to replace monovision as the leading corneal option for presbyopia correction, according to several physicians at Sunday after- noon's presbyopia paper session. Placing the KAMRA inlay in a deep stromal pocket rather than un- der a flap has become the preferred implantation method, and evolution of femtosecond laser technology has improved pocket architecture and bed smoothness, said Alan Faulk- ner, MD, Honolulu. There are now 3 commercially available laser platforms with software capable of making inlay pockets, and Dr. Faulkner reported early results of KAMRA implantation with pockets made by the WaveLight FS200 laser's (Alcon, Fort Worth, Texas) new pocket software. Dr. Faulkner's initial experi- ence implanting the inlay with this laser was excellent, he said. Results showed that out of 10 patients treat- reading glasses, he said. Distance vision was 20/25 uncorrected in inlay eyes, with no compromise in binocular vision, he added. Sev- eral patients experienced dry eye, but showed improvement after 6 months, he said. Eva Liang, MD, Las Vegas, also presented early results with the KAMRA inlay, but she instead used the IntraLase iFS laser (Abbott Med- ical Optics, Abbott Park, Illinois). Although longer follow-up is need- ed, early results with 17 patients suggest the KAMRA inlay procedure improves near vision with minimal compromise to distance vision, Dr. Liang said. After 1 month, 88% of patients saw 20/32 or better at near, com- pared to 10% of patients preoper- atively, she said. All patients had binocular uncorrected distance vision of 20/25 or better, and 63% saw 20/16 or better after 1 month. Majid Moshirfar, MD, Salt Lake City, shared his personal experience creating deep stromal pockets with all 3 femtosecond lasers—the Femto LDV (Ziemer, Port, Switzerland), the IntraLase iFS, and the WaveLight FS200. Each laser has different parame- ters and settings for optimal pocket creation, and surgeons should famil- iarize themselves with differences among the lasers to achieve the best outcomes, Dr. Moshirfar said. He finds the WaveLight FS200 to be faster than the IntraLase iFS, and finds the Femto LDV to be good for surgeons who are used to a micro- keratome. Dr. Moshirfar thinks the Femto LDV is good for making simultane- ous LASIK flaps, he said. When doing concurrent LASIK and KAMRA implantation proce- dures, he recommends starting with the nondominant eye; first create the inlay pocket, and open it to vent it, he said. Then make the LASIK flap and do the ablation in the dominant eye. Finally, go back to the nondom- inant eye, do the ablation, and place the inlay. One major dilemma surgeons face with concurrent procedures is whether to place the inlay first and then do the LASIK ablation, and this is an issue that still needs to be worked out, Dr. Moshirfar said. Dr. Liang pointed out that when she does concurrent procedures, she will do LASIK in the dominant eye, and do PRK in the KAMRA eye. The KAMRA is now her procedure of choice for presbyopia correction, she said, because patients have a better depth of field. If there are any corneal opacities, however, she leans toward monovision. Dr. Faulkner mentioned that he prefers to do LASIK a week before placing the inlay. He has always been successful with monovision, he said, but he sees patients have a bet- ter range of vision with the KAMRA, although their visual acuity may not be quite as sharp. EW Editors' note: Dr. Faulkner has finan- cial interests with Alcon. Dr. Liang has financial interests with Abbott Medical Optics. Dr. Moshirfar has no financial interests related to this article. The fine details of implanting corneal inlays by Vanessa Caceres EyeWorld Contributing Writer C ouldn't catch all of the great educational sessions at this year's meeting? Don't worry—the "Best of ASCRS 2016" general ses- sion today will fill you in on the meeting's highlights. This special wrap-up session will share some of the most important and interesting papers presented at the 2016 ASCRS annual meeting, as selected by EyeWorld magazine Editorial Board members from among the "Best Paper of Session" winners. Fol- lowing summary presentations of the best papers, the section editors of EyeWorld will debate the conclusions and implications in a free-flowing panel discussion. Eric Donnenfeld, MD, EyeWorld chief medical editor, will moderate the session. Session panelists will include Reay Brown, MD, Clara Chan, MD, David Chang, MD, Elizabeth Hofmeister, MD, and Kerry Solomon, MD. Speakers will include Neel Desai, MD, W. Barry Lee, MD, Boris Malyugin, MD, Robert Noecker, MD, and Richard Tipperman, MD. The session will take place from 1:00–2:30 p.m. in Great Hall A and D of the convention center. EW Best of ASCRS 2016 session shines a spotlight on meeting highlights Dr. Moshirfar answers a question about how he performs concurrent LASIK with corneal inlay implantation.

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