Corneal Remodeling to Correct Presbyopia: Mechanism of A Shape Changing Corneal Inlay

Presbyopia is the inability to focus on near objects which physiologically manifests around 40 years of age due to reduction in elasticity of the crystalline lens causing a reduction in accommodation (1). Surgical treatment options include LASIK monovision, multifocal LASIK, accommodate, multifocal, or extended depth of focus intraocular lenses (IOLs), and sclereal expansion techniques. Recently, technological advances have led to corneal inlays as an alternate surgical treatment option to correct presbyopia. Because the inlay procedures are additive and do not require removal of corneal tissue, these  devices can be removed and often times baseline acuity levels recovered with no additional surgey (2). The Raindrop Inlay increases the curvature of the cornea to improve near vision. This shapechanging mechanism involves intricate biomechanical changes to two different layers of the corneal tisssue, which ultimately reduces visual symptoms compared to other presbyopia correcting optical systems such as Multifocal IOLs (3).