Monovision LASIK Versus KAMRA Corneal Inlay

Written by Dr. David Evans   Last modified on September 20, 2018

Presbyopia is that pesky problem we all encounter as we get above 40 years old where we can no longer focus up close without some type of vision correction such as bifocal contact lenses or reading glasses. Given the number of baby boomers out there, correcting presbyopia is a major concern for a large swath of our population. In addition to the common non-surgical treatments like glasses and contacts, there now is an array of surgical treatments to correct presbyopia.

As with any surgery, there are risks, but they are minimal. And considering the convenience factor advantage of surgery, it’s no wonder that many more people are considering a surgical option. With surgery, presbyopia is permanently treated and the annoying problems of forgetting your reading glasses or needing to replace your contact lenses are eliminated.

Through Better Vision Guide we educate about all surgical options for presbyopia correction, but we often receive questions from consumers about how these procedures compare to each other. It can be difficult to respond to all questions, but my aim is to answer as many of the commonly asked questions as possible. For this post I’d like to look at monovision LASIK vs. the KAMRA Corneal Inlay.

KAMRA Corneal Inlay – How it Works

The KAMRA corneal inlay is an ultrathin opaque piece of plastic that is inserted into an inner layer of the cornea. The inlay includes an array of tiny holes and limits the light that can enter the eye. The inlay blocks out many of the light rays that are defocused, thus improving image quality. Read a full article about corneal inlays.

Monovision – How it Works

Monovision is the most widely used surgical treatment for presbyopia correction. It works completely different than an inlay. During the monovision procedure, the focus of one eye is corrected for near vision (i.e. treated so that it can focus only on near objects without correction) and one eye is corrected for distance vision.  Read more about monovision LASIK.

KAMRA Corneal Inlay Vs Monovision LASIK

Monovision LASIK and KAMRA are similar in the sense that one eye is treated for near vision while the other eye is used for distance. Both procedures treat the non-dominant eye for near. As far as similarities go between the two, that is pretty much it.

One advantage of the corneal inlay is that since the focusing power of the treated eye is not affected, the patient can continue to use both eyes for distance vision. This helps to preserve depth perception, which is important for activities like golf and tennis.

Also, because both eyes work together for distance vision, patients often find the adjustment more tolerable than monovision. Some monovision patients find that having one eye focused on near and one eye focused on distance causes considerable discomfort and potential disorientation. (If you are considering monovision, it is best to test the condition with contact lenses first to see if you can tolerate the eyes being focused for different distances.)

The advantage of monovision is that for most patients, it can create much better vision for near tasks than the KAMRA inlay. Also, there is a cost differential. Normally a patient who is treated for monovision is also being treated for distance vision and applying monovision to the treatment is not an extra fee. So, if you decide to have LASIK and would like to have monovision treatment, there is no, or minimal, additional cost. It will still be in the $3,500 to $4,000 range for a high quality surgeon. The KAMRA inlay procedure, on the other hand, is an extra fee and there is no additional benefit other than correcting near vision. The KAMRA fees typically range from $4,500 to $5,000. To be fair, the best candidates for KAMRA inlay do not need distance correction, so for optimal patients cost is a moot point.

One final and rather noteworthy difference between monovision LASIK and the KAMRA inlay is that the KAMRA inlay can be removed if the patient sees no benefit, or if the inlay is not well tolerated. There is no guarantee that quality of vision will return to its pre-KAMRA level, but most patients should experience no issues with reversing the procedure. On the other hand, monovision LASIK treatment is permanent. Although in some cases, patients can have the near eye retreated so that it focuses on distance objects, just like the other eye.

If you are considering monovision LASIK but are interested in learning more about the KAMRA inlay, speak with your ophthalmologist to discuss which option might be a better fit for you. You can also visit the KAMRA website to read more about the newly approved inlay and to check your suitability.