KAMRA Inlay- An Ophthalmologist's Experience

The Day BeforeWritten by Dr. Ronan Conlon, Medical Director, Horizon Laser Vision Center, Saskatoon, August 2nd, 2013

Dr.Conlons Well .... I am ready to go! My KAMRA Inlay procedure is today Friday, August 2nd (in less than 3 hours). I'm excited. I had my pre-op Wednesday - went great. A bit of challenge finding the edge of my previous LASIK flap .. but all good. Location - Crystal Clear Vision, Toronto. Beautiful centre. Great staff. Put me totally at ease ... hey being an ophthalmologist and totally control orientated (too put it nicely) that's not easy ... so good job, Sondra and staff. Like many others, I have had LASIK (2000) and enjoyed being spectacle independent for years. Now hit 50, well 52:) ... and struggling with near vision, or the lack thereof. My correction is plano RE and -0.50 sphere LE, so I have a bit of mono-vision (able to see a bit up close with my left eye) ... but it's fading daily as presbyopia (inability to read up close) sets in. Patient mode has been interesting for me ... and I look forward to sharing the experience. Stay tuned!

The Next Day

Written by Dr. Ronan Conlon, Medical Director, Horizon Laser Vision Center, Saskatoon, August 3rd, 2013

I survived it ... and all is well. My eye feels fine, and my vision is a bit blurry, but much better than yesterday ..... I can already see my iphone easily. I know it can take up to a month or two to achieve the full benefit of the implant - so patience, and drops, drops, drops.

The experience yesterday got "my attention". Everyone is nervous about eye surgery, but I thought I did a fairly good job keeping my emotions in check, and I felt reasonably relaxed under the laser (no Ativan ....maybe I should have taken it).

I had a great conversation with Jeff Machat before the procedure, and he put me totally at ease. Jeff has had the procedure himself, so he understands it from both sides.

Dr. Machat cautioned me about the amount of pressure I would feel on my eye during the procedure (necessary to flatten the corneal enoough to implant the KAMRA Inlay). He said about an 8/10 for discomfort, and that was accurate. But it was certainly tolerable.

The creation of the flap took about 25 seconds .... and it's a long 25 seconds when you are laying there not able to see anything (its normal for you to lose the red light, and things turn dark), but Jeff's steady count down, interspersed with the surrgical mantra "prefect" "perfect" "perfect" makes a huge difference.

Post procedure I went back to the hotel, and took a nap (decided to take an Ativan). Did not sleep great the night before ....wonder why? I was tired. My eye became moderately irritated about 30 minutes post surgery, and I think I was forgetting to blink, and doing a lot of talking (deviating from patient mode).

After taking a nap for 3-4 hours I was feeling so good, I took a slight deviation from the sleep all night plan. My son Ronan arrived to the hotel from Ottawa, so I decided to go out for dinner .... I took my drops, but in retrospect I probably should have stuck to doctors orders, and stayed in bed with my eyes shut ....I certainly got scolded by Jeff this am, but I am back on track now:) I did not ask the common question "was I a good patient?" .... I knew the answer!

I am very pleased ... more updates to come.

Day 12

Written by  Dr. Ronan Conlon, Medical Director, Horizon Laser Vision Center, Saskatoon, August 14th , 2013

Sorry I meant to post after my one week follow up visit, but I was travelling back to Saskatoon that day, and its been hectic since my return home. Well ..... all is well! Using my iPad, iphone, and computer all without glasses. Great! I was in the OR today, and did 26 cataract surgeries, and it was neat being able to load the implants with my "naked" eye, and not having to resort to using the microscope (well I did on one case, but 25/26 is not bad). It just made everything easier in the OR - what a convenience!

I saw Jeff last Friday for the 1 week post op visit, and the KAMRA was in a perfect position. There was minimal to no inflammation. The KAMRA implant position was confirmed under the Tagaki surgical microscope which is Jeff's preference. From my persepective my KAMRA eye was perfectly comfortable. I had become a "good patient", and was using my drops as instructed (which still proves to be a bit on a challenge, but easier now that I am back to work... no shortage of drops in my work environment:)

I do notice some mild fluctuations in my vision, and I get moments of "super clear" vision, especially outside ... which is pretty exciting. I view that as a harbinger of even better things to come. The near vision is very light dependent, and the more light the light, the smaller the print I can read.

At times, it feels as if my eyes are figuring which one kicks in for distance, and which on for near ... but it is effortless, so I do not really think about it, and I have tired to quit doing the the "refractive surgery salute" (that's putting your hand over one eye, then the other, to compare the vision) ..... I think I drove my wife, Susan, crazy doing this for the few days after surgery .... I should know better.... but we are all human.

In all seriousness, if there was no further imporvement in my vision I would be satisfied, but hey, I am only 12 days out. Be patient! The photo below is "My KAMRA" one day post op.


For more information about Dr. Conlon visit his website at: www.conloneyeinstitute.com

An Interview with Dr. Conlon: KAMRA vision

Written by Ronan Conlon

Brent Loucks: Welcome to another half hour of our Talk to the Experts on News Talk Radio and we have got a vision expert with some big, exciting news for people in this part of the world. It's Brent Loucks, your host and I'm joined today by Dr. Ronan Conlon. You'll know Dr. Conlon from the Horizon Vision Center here in Saskatoon. He's also got Conlon Eye Institute, but as you could tell - I'm already excited about this program because it's something I've been wondering about and asking different people in the world of optometry over the years. When are we going to see something like this? Well, here today to talk about KAMRA vision. Welcome to the program, Dr. Conlon.

Dr. Conlon: Well, thanks for having me on Brent. It's a pleasure to be here.

Brent Loucks: This is so cool because I think probably one of your typical patients or somebody who would be very interested in the product that we're going to be talking about today. We all have known over the years where there's been different laser surgery for different eye conditions, but for the average middle-aged person who has their collection of reading glasses - up until now there hasn't been anything to give me a fix for that. You're here to tell me today, there is a fix now.

Dr. Conlon: Well, I believe there is Brent. It's interesting because what you're talking about presbyopia or the inability to see as up close as you reach your 50s. That's been one of the last big areas of refractive surgery where we try to help people. There's been relatively a new product that's been approved in Canada, but been around for about 10 years called the KAMRA inlay, which I actually have had one implanted in my own eye, which solves the problems of presbyopia. Allows people to see up close again in their 50s, which is I think going to be a great advancement - there is a great advancement.

Brent Loucks: So what's the backstory in presbyopia? What's going on in my eyes that I'm one of those guys that grew up - I was always so proud. I had 20/20 vision, and I could see a long way off and I could see up close and then all of a sudden I hit my late 40s and things started to change. What's going on in the eye?

Dr. Conlon: What’s really going on there is we rely for our whole lives for the ability of the eye to be able to accommodate to see up closely. As you get older, usually from your mid 40s onwards that muscle that does the accommodation called the ciliary muscle get stiff. That stiffness doesn't allow it to be as flexible as it used to be and consequently, you don't have that fine vision that you had up close anymore - you lose that. It's just a natural aging change of the eye.

Brent Loucks: So what does the KAMRA process--I'm looking at this. You brought this in. You brought this tiny, tiny little doughnut.

Dr. Conlon: Yes.

Brent Loucks: What is it and what does it do?

Dr. Conlon: It’s a very simple device in a sense of it. It works in what's called a pinhole principle. Sometimes you'll see kids if they have problem seeing they'll put their fingers together and make a tiny little hole and look through it and they'll see things clearer. What that pinhole does is that it weeds out or blocks off rays that aren't going right on the retina. So with the pinhole the rays of light get focus right on the retina and it allows you to see up close again. The beauty of this pinhole effect is that it doesn't really cause any aberrations in your vision or any other problems. It doesn't affect your distance vision, so when you put one of these KAMRA implants in the cornea, it doesn't interfere with your distance vision, yet enhances your near vision. So it's an elegant solution to a complicated problem.

Brent Loucks: So the name KAMRA, it's almost like the old pinhole camera that we're talking about.

Dr. Conlon: Exactly, and I think the company that made it that's a marketing name the KAMRA, but it's a neat name.

Brent Loucks: Does is work? As you said, you not only put this in but you've got one in one of your eyes.

Dr. Conlon: No. It works great. I believe on August 8th, I went out to Toronto and I had a friend of mine put the KAMRA in my left eye; it took about 20 minutes. It's interesting because I had LASIK surgery, like many people in my early 30s about 15 years ago. Then I hit about 48 and I was really having problems at work, especially with computer vision - seeing at the computer. Then working in the OR because I do things and if I didn't have glasses on, then I'd have to use a microscope, and it's just an annoyance and I'm looking down instruments all the time. So, wearing glasses was just annoying to me, especially when I hadn't had to do it for 15 years. So the KAMRA has been working great for that and I don't even think about it now. I think for the first month or two, I understand what you're not supposed to do and that's cover one eye and the other eye and comparing and it was interesting. My wife said to me, "You know, you tell all your patients not to do that. Why are you doing it?"

Brent Loucks: You’re the doctor. No, now, you’re the scientist…

Dr. Conlon: Right now, I'm just not even aware that it's there except for the fact that I'm not looking for my reading glasses all the time.

Brent Loucks: That's just crazy. You just had it done in one eye.

Dr. Conlon: In one eye, yes.

Brent Loucks: Do I get a sense when I have it in just one eye of that eye favoring my vision?

Dr. Conlon: No. You really don't. It's amazing that the brain has amazing plasticity to it and that when you look up close the brain just automatically takes that close image from the left eye kind of ignores the right and you don't consciously do that, or you don't even have to think about it - it just happens.

Brent Loucks: What kind of adjustment you went through? You had this done in August. What did you notice in the early days?

Dr. Conlon: I would say for about the first week or so, although the day after the surgery I could see well in the distance and well up close. I notice that what I say was a slight haziness and where the quality of the vision that I used to wasn't just quite there in my left eye. That was because to put this implant in, you have to make a special laser cut in the cornea. You do get a bit of swelling of the cornea and that's a natural thing. Then for most people over the first two months up to three months, you get a steady improvement, and that's been my case. So for the last couple of months after about three or four weeks, it was great and it's maintained that. It seems they got a little bit better as time goes on.

Brent Loucks: You, for the most part can read, like we're looking at these papers right here - a foot in front of us and you don't need glasses.

Dr. Conlon: No, nothing. I can read the newspaper easily. I do find if I'm at a restaurant, like some place that's darker, steakhouse or something that I still need good light and that was an annoyance to me at the beginning, but I got used to using my iPhone - that little flashlight. I just thought that on and I can read anything with it.

Brent Loucks: This is fascinating. Dr. Ronan Conlon is our guest this half hour Talk to the Experts and we're talking about a procedure now available here in Saskatchewan. Are you the only person right now doing this in Saskatchewan?

Dr. Conlon: I am the only one at the moment, but we are having other surgeons that are undergoing training and I think will be onboard soon in doing the procedure.

Brent Loucks: You can find out more. You just Google KAMRA, K-A-M-R-A, you'll get the story on it, but go to the Horizon Vision Center website. You could Google Horizon or go to Dr. Conlon's own website - Conlon Eye Institute here in Saskatoon. Just fascinating procedure now and I'm saying like me, I've been wearing my reader's. How many people are like the situation? I've got this thinking glasses all over the place and it just drives me crazy some days and as I get older it seems to get worse and worse. I think I'm on 150s right now. [chuckles]

Dr. Conlon: Yes. Probably about right. People have different strategies for that. Some people carry multiple pairs on them. I was in the strategy of trying to leave them at different places I know I would need them - the car, the computer, et cetera. So it's just great to be free of that.

Brent Loucks: You mentioned that you had undergone the other kind of laser surgery - the LASIK surgery--

Dr. Conlon: LASIK, yeah.

Brent Loucks:—in your 30s. So it's not a problem, if I've had one type of eye surgery like this to step to the KAMRA surgery?

Dr. Conlon: No. That's a great plus of this procedure. What we're able to do on people that have had previous LASIK surgery is we're able to go beneath the flap that they already had with the special laser. It's called the femtosecond laser and we're able to cut a little pocket below their existing flap and slide this thing, so it's quite an elegant procedure; it probably takes about 20 minutes to do. The other scenario that we sometimes see is people that come in that are a little bit nearsighted, but they want to get that corrected for the distance, but their 50 years of age and if you correct their nearsightedness - then they won't be able-- they'll lose that and they'll need reading glasses. So now we're able to correct these people in their 50s for the distance and then we put the KAMRA in three days later beneath the flap. I've done about seven or eight of those procedures just recently in the last few weeks and they're working out very well, so there's a lot of versatility in this procedure.

Brent Loucks: From your studying of other case studies, other scenarios, other doctors - any long-term issues with this KAMRA system?

Dr. Conlon: The actual materials have been used in the eye for over 10 years now and they've modified the actual KAMRA implant itself, but there's been no long-term complications or problems with it. I certainly hope that's not the case because I got one in my own eye. So I'm very comfortable with it.

Brent Loucks: Well, that's fascinating and no doubt that's a real plus. It's the old physician heal thyself here -where you've actually gone out and had this procedure done and you can speak to it in ways I suppose most other doctors in this situation probably can. You're living it.

Dr. Conlon: I think that it's very true, it certainly gives me an appreciation from the patients' perspective what they're going through. I had a very real need for it being 50 and I had researched the technology and I had met other ophthalmologist or friends of mine in the US that I've worked with that had had it and they're very pleased and I'm very pleased as well. I think one nice feature about it if someone did have a problem it is a reversible procedure.

Brent Loucks: Really?

Dr. Conlon: That appealed to me that worst case scenario if I didn't like it for whatever reason - it can be removed - so that's a nice feature for people as well.

Brent Loucks: Boy, if you're listening to our radio program today, for a lot of us middle-aged people it's hallelujah time. Throw away the readers if you want to take advantage of this incredible new surgery now being offered through Horizon Vision Center here in Saskatoon, the Conlon Eye Institute. Dr. Ronan Conlon, our guest - he's the only person in the province doing this right now.

Dr. Conlon Without Glasses