Cornea is like a transparent watch glass situated in front of the eye. It appears black or brown from outside due to the dark structures situated underneath
Cornea can become cloudy or opaque leading to decreased vision or even severe loss of vision. The opacity of cornea is caused due to any severe infection (corneal ulcer) or trauma / injury. These patients will require Corneal Grafting Surgery.
Corneal Grafting or KERATOPLASTY is carried out to replace the damaged cornea with a clear one with sutures. This clear cornea is obtained from the donated eye of a deceased person. The latest techniques involve sutureless corneal transplant techniques like DALK- Deep Anterior Lamellar Keratoplasty and DSEK- Desemets Stripping Endothelial Keratoplasty.
Myopia or short-sightedness is a condition in which the rays of light reaching the cornea (the clear front portion of the eye) are focused in front of the retina (the light sensitive portion of the eye). The resulting vision is thus, not clear and close objects are seen well than those at a distance.
Corrective Lenses: Contact lens and spectacles alter the path of the light rays to achieve precise retinal focus.

Conductive Keratoplasty

Conductive keratoplasty (CK) is a non-laser refractive eye surgery design ed to correct mild hyperopia and help people who are middle-aged and older reduce their need for reading glasses after they become presbyopic. Refractec Inc. (Irvine, Calif.) markets the CK procedure under the trade name NearVision CK.

More About Conductive Keratoplasty

Unlike LASIK, PRK and other laser-based procedures, Near Vision CK uses low energy radio waves to reshape the cornea and restore near vision.
During the CK procedure, your eye surgeon uses a hand-held instrument with a tiny probe (smaller than a human hair) to apply low-level, radio frequency (RF) energy to specific spots that form a circular pattern on the outer part of the cornea.

Connective tissue then shrinks where the RF energy was applied, causing the circular band to act like a belt that "tightens" and steepens the cornea. This change in the curvature of the eye's surface affects the way light rays enter the eye to bring near vision back into focus.

Unlike LASIK or PRK, no tissue is removed from the eye during a Near Vision CK procedure that takes only a few minutes.
CK also is being investigated as a way to correct certain types of astigmatism that create an irregular eye surface due to trauma or surgical incisions.

In conductive keratoplasty, low heat energy from radio frequency is applied through a probe to reshape your eye's surface.

Conductive Keratoplasty and Monovision

If you have clear distance vision and your only problem is poor near vision due to presbyopia, conductive keratoplasty is performed on only one eye. This creates a mild form of monovision, meaning that one eye is corrected for near vision while the other eye is stronger for distance vision. As may happen with monovision with contact lenses or a LASIK eye surgery procedure, your driving vision with this type of vision correction may be less sharp than it is when both eyes see clearly in the distance. So you may find a pair of eyeglasses for night driving useful after CK.

While CK can improve near vision, the procedure doesn't cause as much blurring of distance vision as mono vision with contact lenses or laser vision correction procedures such as LASIK. Studies indicate that the CK procedure may alter the cornea in such a way that a slight multifocal effect is achieved, creating "zones" through which the eye may be able to see at different distances.

Prior to a conductive keratoplasty procedure, your eye doctor may recommend that you first wear a contact lens for near vision correction on one eye for a period of time to make sure you are able to adapt to monovision. But this is not a requirement. People who adapt well to a monovision contact lens fitting typically are able to tolerate a CK procedure.
During your CK consultation, your eye doctor may conduct another test that involves holding a +1.00 diopter lens for near vision correction in front of your non-dominant eye.
This way, you can experience (with both eyes open) what it is like to have one eye see better at a distance and the other eye see better close up. If you notice a significant blurring of your distance vision during this test with both eyes open, you may not be a good candidate for the procedure.

If you still can see clearly across the room under these circumstances, you likely will adapt well to CK.

Are You a Good Candidate for CK?

You may be a good candidate for NearVision CK if your eyewear prescription has been stable for at least one year and you:

Are over age 40.
Have had good distance vision your entire life but now need reading glasses.
Are willing to accept slight distance blur

Is Vision Correction From Conductive Keratoplasty Permanent?

Even though CK effects are long-lasting, they are not permanent.
Also, effects of CK can be temporary because your eyes will continue to change as presbyopia worsens.
When you look at a reading glasses rack at the store, for example, you see +1.00 power readers for a 40-year-old, +2.00 power readers for a 50-year-old, +3.00 power readers for a 60-year-old and so on.
Even though you eventually will need reading glasses again after CK, you still may retain good intermediate vision, enabling you to see a computer screen and view a cell phone without glasses.
Great candidates for CK are those who want to delay the need for reading glasses.
And when reading glasses are needed, these candidates still might appreciate having functional vision in the intermediate range.

Steps To Take Before Undergoing Conductive Keratoplasty

If you are considering NearVision CK, you first need to choose a refractive surgeon who is experienced with the procedure. Your doctor will examine your eyes thoroughly to determine if you are a good candidate.
During your consultation, an instrument called a corneal topographer will be used to create a detailed map of the curvature of your cornea. The topographer doesn't touch your eye, and the measurement is similar to having a close-up photograph taken of your eye's surface.
The corneal topography map will display the various steep and flat corneal curvatures that the surgeon must take into consideration while conducting the procedure.

What Happens During CK?

Conductive keratoplasty can be performed in the ophthalmologist's office. The surgeon will apply some anesthetic eye drops to your eyes and then use a small support device called a speculum to keep your eyelids open and prevent blinking.
Using a rinse-away dye, the surgeon will imprint a treatment pattern on your cornea, showing where the radio frequency energy should be applied.
A hand-held probe then is used to deliver the energy to a specific depth within the cornea at these spots. The entire procedure takes only a few minutes.
NearVision CK is painless, but some people say they feel a slight pressure on the eye.
If you are being treated for hyperopia, both eyes can be addressed during the same visit. In this case, the procedure involves virtually no down time.

Steps To Take After a Conductive Keratoplasty Procedure

After surgery, you will be given a prescription for eye drops that help prevent infection and reduce inflammation. Some surgeons may ask you to wear special bandage contact lenses for a few days, to minimize discomfort.
You can leave the doctor's office right after conductive keratoplasty, although someone else must drive you home.
You may experience a foreign body sensation when the topical anesthetic wears off (about 20 to 30 minutes after the procedure), similar to the feeling of having a piece of dirt or debris in your eye. This sensation usually subsides within 24 hours.
Although you typically will be able to function normally the day after surgery, you may be slightly nearsighted for a few weeks or even months. This may cause noticeable blurring of your distance vision.
You also may experience mild vision fluctuation, and your eyes may be sensitive to bright light after surgery. If these side effects occur, they usually will clear up within a few weeks.
For at least one week after surgery, you should avoid swimming, using a hot tub or participating in any other activities where water may splash into your eyes. When showering during this period, keep your eyes closed as much as possible, and direct the spray away from your face.

When To Avoid CK

You should not undergo the NearVision CK procedure if you wear a pacemaker for regulating your heart beat. The radio frequency equipment may interfere with the proper operation of these electronic devices.Also, your eye doctor will advise you if you have any other conditions such as severe dry eyes that would eliminate you as a candidate for CK.

What To Expect After Conductive Keratoplasty

CK is one of the safest procedures performed for near vision correction because, unlike other procedures, it does not involve cutting or removing tissue. Instead, CK gently reshapes the cornea with radiofrequency waves to reduce the need for reading glasses.
Therefore, complications sometimes associated with other vision correction procedures, such as dry eyes, are less likely with CK, because it is relatively non-invasive.
Though the near vision benefits of CK will not last indefinitely, the procedure often is an excellent choice for people who want relief from reading glasses and have proper expectations about CK.
Even if reading glasses are needed again several years after CK, the procedure usually continues to provide improved vision without glasses for computer use and other visual tasks at arm's length.

Kamra Inlay

Kamra Inlay in If you are over the age of 40, you've probably noticed that near objects are beginning to appear out of focus. You may be experiencing a condition called presbyopia. With presbyopia, the natural lens of the eye has lost its flexibility. The lens does not readily change its focus from distance to near. As a result, near objects are blurry. Until recently, reading glasses were the primary option for people with presbyopia. However, many people prefer not to wear reading glasses because they can be inconvenient to use, inaccessible when needed the most, or unappealing for cosmetic reasons.

One of the options to decrease dependency on reading glasses is the Kamra inlay. Other surgical options include monovision LASIK or PRK in which one eye is treated for distance vision and the other for near, monovision refractive lens exchange, or a refractive lens exchange with a multifocal intraocular lens. At Our place a comprehensive evaluation including digital testing is performed to determine the best choice to provide both distance and reading vision.

What is the kamra inlay?

The Kamra inlay is actually a very simple device and utilizes an optical principal that has been known for thousands of years but that has only relatively recently been adapted for use in the eye-care field.

The Kamra inlay is a microscopic black ring with a tiny aperture or hole in the centre. It's smaller than a contact lens, lighter than a grain of salt, and virtually invisible when inserted. The small aperture increases the depth of focus to enhance near objects and maintains distance vision. The inlay is inserted beneath a LASIK flap or pocket to enhance reading vision. The procedure is reversible.

Kamra Inlay with a small central opening that helps focus vision for reading.
The Inlay is much smaller and thinner than a contact lens.

"The corneal inlay can be performed at the same time as the LASIK procedure or in patients that have previously had LASIK or PRK".
The inlay has a diameter of 3.8 mm with a central opening of 1.6 mm and a thickness of 5 microns. This thickness is 1/10th the thickness of a human hair. There are 8,400 high precision, laser etched micro-openings in the opaque part of the disc. These holes help maintain a healthy cornea by allowing glucose, oxygen and other metabolites to pass through

"Patients that have had other types of eye surgery, whether it be laser vision correction or cataract surgery can now benefit by the Kamra inlay. The Kamra inlay is a revolutionary device that is so simple in principle but with a dramatic effect in its ability to restore reading vision".

How is the Procedure Performed?

The Kamra inlay is implanted under a LASIK flap once the prescription has been lasered to -0.75. For patients who do not require simultaneous LASIK, the Kamra inlay is placed into an intra-corneal pocket created by the femtosecond laser. The inlay is positioned over the line of sight using a sophisticated alignment system. The Kamra is implanted into one eye only and this is the eye that then enjoys the enhanced near vision. The distance vision remains very good. The procedure is also completely reversible: for anyone who does not like the result, the inlay can be removed.

Kamra Inlay with a small central opening that helps focus vision for reading.
The Inlay is much smaller and thinner than a contact lens.

How does the Kamra work?

The KAMRA inlay is an implant designed to reverse the effects of presbyopia and restore near and intermediate vision by using small aperture optics, the same principle used in a pinhole camera.

When inserted in the cornea the dark ring of the Kamra inlay serves to block out unfocused light while the small opening in the centre of the inlay allows focussed light to reach the retina. This means that vision is enhanced at all distances looking at a movie screen, working on a computer, and also reading text on a cellular phone.

With focused light rays, you can enjoy a wider range of improved vision for all distances near, far and in between. The small-aperture technology is a superior alternative to options that use a multi-focal approach.

What are the Advantages of the Kamra inlay

The KAMRA inlay is designed to improve functional near vision and reduce dependency on reading glasses. Although eliminating the need for reading glasses typically occurs, you may occasionally need reading glasses for reading in dim light, or reading very small print. The Kamra inlay offers effortless natural vision, and by having the inlay implanted there are significant advantages over reading glasses or contact lenses.

Reading Glasses Kamra Inlay
Easy to misplace An implant that offers unparalleled ease and convenience.
Blur distance vision Brings near objects into focus. Distance vision remains virtually unchanged.
Visible indicator of aging/vision loss So small it is nearly impossible for others to see.
Not ideal for all No lenses that smudge or fog up.
activities/conditions. No bulky glasses that limit activities.
Contact Lenses Kamra Inlay
May be hard to position and/or easy to lose. No need to reposition or struggle with the inlay. It won't move or fall out.
Ongoing replacement and upkeep cost. Hassle-free, long-term benefits after being implanted in one eye.
Not for long-term or overnight use. Safe and effective long-term solution for improving near vision.
Only improves vision if worn. Works continuously.
LASIK & Cataract Surgery Kamra Inlay
May diminish near vision. Revives near vision even after these common procedures.
Your First Step

Contact a KAMRA™ Inlay Specialist Today

If you're ready to take the next step, the KAMRA™ inlay can take you on a journey of near vision rejuvenation. There's nothing like the ease, convenience and clarity of this remarkable inlay. So, why wait? Get started today

Every doctor listed on our site is trained to examine your eye health and history and determine if this technology is right for you. It's time to feel more confident and in control. Just imagine taking back the freedom to enjoy your everyday activities without having to reach for your reading glasses. That's the power of change and the power of the KAMRA inlay. Natural vision for everyday living.