A corneal inlay is a small implant placed within the corneal stroma of one eye to improve near vision in presbyopia. It modifies the optical properties of the cornea without removing the natural lens.
Designs and Mechanism
Some inlays act as a pinhole to increase depth of focus, while others change curvature or refractive index. They are inserted into a femtosecond‑laser‑created pocket or under a flap.
- Typically implanted in the non‑dominant eye as part of a monovision strategy
- Removability is an advantage if vision or tolerance is unsatisfactory
- Availability has decreased in some regions due to variable outcomes
- Careful screening for dry eye and corneal disease is vital
Risks and Outcomes
While some patients achieve good near function, complications such as haze, glare, or reduced contrast have limited widespread adoption. Many centres now favour lens‑based solutions instead.
- Regular monitoring checks corneal clarity and implant position
- Explanted eyes often recover baseline vision, but subtle changes can persist
- Patients must understand the trade‑off between near gain and potential distance or quality‑of‑vision changes
- Long‑term safety data are still evolving for some designs
