Debate over the ideal implantation depth continues, Dr. Hoopes added.
The discussions are similar to those surrounding the residual stromal bed for LASIK with some surgeons recommending 250 μm, whereas others see advantages in 300 μm.
Dr. Hoopes noted his practice has several patients with inlays as deep as 300 μm.
The ideal implantation depth depends at least in part on the preoperative corneal thickness. The Kamra advisory board currently recommends implantation at 40% of the cornea depth, he noted.
“If you implant at the [minimum] depth on the label, you tend to see a hyperopic change in refraction beyond 3 months,” he said. “When you implant deeper than 250 μm, patients have refractive stability for at least the first year and better visual acuity than a shallow implant. There is a clear difference in clinical performance with deeper implantation.”