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What Is a KAMRA Inlay (Pinhole)?

A KAMRA inlay is a small-aperture, pinhole-style implant placed within the cornea to improve near and intermediate vision in presbyopia. It works by increasing depth of focus, similar to the pinhole effect, so more objects appear in focus. The inlay is typically implanted in the non-dominant eye, and the procedure can be reversed by removing the device if needed. While the device remains FDA-approved, major ophthalmology guidance has noted it has not been produced or sold since 2022 in many markets.

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What Is a KAMRA Inlay (Pinhole)?

A KAMRA inlay is a small-aperture, pinhole-style implant placed within the cornea to improve near and intermediate vision in presbyopia. It works by increasing depth of focus, similar to the pinhole effect, so more objects appear in focus. The inlay is typically implanted in the non-dominant eye, and the procedure can be reversed by removing the device if needed. While the device remains FDA-approved, major ophthalmology guidance has noted it has not been produced or sold since 2022 in many markets.

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How Does the Pinhole Inlay Work?

The inlay has a central opening that limits unfocused peripheral light and lets more focused rays reach the retina. This can sharpen near vision in one eye while the other eye maintains better distance focus, creating a blended-vision effect. The device is placed within a corneal pocket or under a flap, depending on the surgical technique. Because the cornea must remain healthy, careful screening is important before considering any corneal implant.

Who Was Considered a Candidate?

Candidate selection focused on presbyopic patients with otherwise healthy eyes and stable distance vision. The inlay was commonly placed in the non-dominant eye to reduce the impact on distance vision tasks. A full evaluation typically included corneal imaging, dry eye assessment, and a review of any prior refractive surgery. People with significant ocular surface disease, corneal scarring, or uncontrolled inflammation were often not good candidates.

Benefits and Tradeoffs

Many patients reported improved ability to read without glasses for some tasks, but outcomes vary. Tradeoffs can include reduced night vision quality, dimming, or less crisp distance vision in the implanted eye. Some people also require additional vision correction for certain activities even after implantation. Your clinician weighs potential benefits against tolerance for visual compromises.

  • Potential near and intermediate improvement
  • Possible glare, halos, or reduced contrast
  • Vision may still require glasses for small print

Risks, Removal, and Availability

Risks can include corneal haze, inflammation, dry eye symptoms, infection, or dissatisfaction with visual quality. The inlay can usually be removed, but some patients may have residual haze or refractive change after explantation. Because production and implantation have declined in recent years, many current visits involve monitoring existing inlays or managing complications rather than placing new ones. If you have a KAMRA inlay and notice increasing blur, glare, pain, or redness, seek prompt ophthalmic evaluation.

FAQs on the KAMRA Inlay

Is the KAMRA inlay still available?

It remains FDA-approved, but multiple ophthalmology sources have reported it is no longer in production and has not been sold since 2022 in many markets. Availability can vary by country, so your ophthalmologist can confirm what is currently offered locally.

Can the KAMRA inlay be removed?

Yes, it is generally designed to be removable. Removal may improve symptoms caused by haze or visual dissatisfaction, but some people can have lingering corneal changes that need ongoing care.

What are common side effects or complications?

Possible issues include glare or halos, reduced contrast, dry eye symptoms, corneal haze, and the need for explantation. Your clinician will also monitor corneal health, refraction changes, and ocular surface status during follow-up.

What are alternatives for presbyopia?

Alternatives include reading glasses, monovision contact lenses, multifocal contact lenses, and presbyopia-correcting intraocular lens options for people who also need cataract surgery. The best choice depends on your vision goals, corneal health, and tolerance for visual tradeoffs.

References

Premarket Approval (PMA) P120023: KAMRA INLAY. U.S. Food and Drug Administration. https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpma/pma.cfm?id=P120023. Date Accessed February 2, 2026.

Premarket Approval (PMA) P120023: Decision Date (Approval). U.S. Food and Drug Administration. https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpma/pma.cfm?id=P120023. Date Accessed February 2, 2026.

Long-term changes in keratometry and refraction after small aperture corneal inlay implantation. PubMed. https://pubmed.ncbi.nlm.nih.gov/30323549/. Date Accessed February 2, 2026.

Long-term outcomes after monocular corneal inlay implantation for the surgical compensation of presbyopia. PubMed. https://pubmed.ncbi.nlm.nih.gov/25726504/. Date Accessed February 2, 2026.

Complications of Small Aperture Intracorneal Inlays. PubMed Central (PMC). https://pmc.ncbi.nlm.nih.gov/articles/PMC9965951/. Date Accessed February 2, 2026.