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Corneal Inlays or LASIK: Which Is Right For You?

By Beth Krietsch
Medically Reviewed by Kerry D. Solomon, MD, and member of the Refractive Surgery Council editorial advisory board on December 10, 2020
Corneal inlays and LASIK surgery can both be effective treatments for people with presbyopia. Here's what you need to know about each.

For people with presbyopia, who have trouble seeing or focusing on close objects like a phone or newspaper, treatments like corneal inlays, LASIK surgery, contact lenses, or eyeglasses can all be effective.

Presbyopia is a common eye condition that many people experience when they reach their 40s or 50s as the eye’s lens becomes more rigid. This rigidity can make it harder to focus on objects that are nearby and may contribute to eye strain and headaches. Presbyopia can’t be stopped or reversed, but treatments like corneal inlays and LASIK surgery can help restore your vision for looking at objects up-close.

A corneal inlay is a small implant in the thickest layer of the cornea. The procedure takes about 10 to 15 minutes and is done under general anesthesia, meaning you will be awake but won’t feel pain in your eye area while the procedure is in progress. During the procedure, a laser cuts a small flap or pocket in the middle of the cornea on your non-dominant eye. The corneal inlay is then placed in this pocket or flap and helps correct your vision by increasing your depth of focus.

You may experience side effects from corneal inlays, including glare, difficulty with night vision, or corneal scarring, inflammation, or swelling. It’s possible to remove corneal inlays if you are not pleased with the results following your procedure.

LASIK is a surgery to treat myopia and other refractive errors such as hyperopia and astigmatism. This treatment is an option for people who are 18-years-old or older with healthy corneas and good eye health. LASIK isn't recommended for people with changing refractive errors and other conditions including untreated dry eye, corneal abrasions, uncontrolled diabetes, advanced glaucoma, or extreme refractive errors.

At this point, you may be wondering whether a corneal inlay is a good option for you, or if a treatment like LASIK surgery might make more sense. Generally, corneal inlays are recommended for people who are between the ages of 40 and 60 and suffer from presbyopia, but your ophthalmologist can help you figure out if you’re a candidate for a corneal inlay procedure or LASIK.

Corneal inlays can be a great option if you are free from diseases of the cornea and don’t suffer from a refractive error like hyperopia, astigmatism, or myopia. If you do suffer from one of these refractive errors, a combination of LASIK and a corneal inlay may be needed. The American Academy of Ophthalmology points out that some LASIK and corneal inlay combination procedures are considered “off-label” use of corneal inlays by the Food and Drug Administration (FDA). Corneal inlays are not recommended for people with cataracts or those with uncontrolled dry eye or blepharitis.