Presbyopia is the natural age-related decline of the eye’s ability to focus at near. For most people, the effects start becoming noticeable around 45 years of age but it is not uncommon for difficulties to manifest at an earlier age. The lens inside the eye is made of a central nucleus, surrounding lens fibres, all contained within the lens capsule. In a young eye, the lens is flexible and able to adjust its shape to focus on near objects, controlled by the ciliary muscle.
However, beginning from birth, lens fibres are continuously being formed around the nucleus, resulting in the lens stiffening and becoming progressively less flexible. It is when we begin to notice our eyes don’t focus so easily up close that this is then considered presbyopia.
Laser Eye Surgery for Presbyopia
In the past, vision correction options were quite limited for people looking for a solution to presbyopia. Laser eye surgery is traditionally employed to address issues associated with distance vision, such as myopia (short-sightedness), hyperopia (long-sightedness), and astigmatism.
However, for a patient who is, for example, both hyperopic and presbyopic, traditional laser eye surgery vision correction methods did not always provide the freedom from glasses or contacts that the patient may have been hoping for.
Options for surgical vision correction in presbyopia were previously limited to an arrangement known as monovision, which was a technique using laser eye surgery, such as LASIK or PRK, to correct one eye for distance vision and the other for near vision.
Although this works well for many people, monovision vision correction carries some disadvantages such as compromised depth perception, difficulties with adaptation, and a blur zone at intermediate distances.
Laser eye surgery for presbyopia patients has now been revolutionised with the advent of Presbyond.
Presbyond Laser Eye Surgery for Presbyopia
Presbyond is similar to the LASIK laser eye surgery procedure, but instead of correcting each eye solely for one focal distance (whether both for long-distance or one for distance and one for near as in the case of monovision), Presbyond performs what is known as ‘laser blended vision’. This provides a degree of both distance and near vision to both eyes while accounting for the dominant eye to optimise clarity. This helps to circumvent many of the difficulties of traditional monovision – as both eyes are used to some degree for viewing all distances, this carries less of an impact on depth perception.
The blended nature of the vision correction also results in some intermediate vision, such as for viewing desktop monitors. The concept of blended vision correction is not exclusive to laser eye surgery for presbyopia. An important part of assessing a patient’s suitability for Presbyond is the use of a multifocal contact lens trial. The different focal zones within the contact lens simulate the sort of visual experience a patient can expect from Presbyond laser eye surgery. The brain still requires some adaptation around this new experience as it will now be receiving a different type of visual input from both eyes with the contact lens trial helping to ascertain whether a patient is easily able to tolerate this vision.
Treatment is performed under local anaesthesia with a refractive specialist eye surgeon. A femtosecond laser is used to create a thin hinged flap of corneal tissue at the front surface of the eye, which is then set aside to give access to an excimer laser to reshape the underlying layers of the cornea. It is this reshaping process, guided by a pre-calculated computer algorithm, that sculpts the cornea in a specific way such as to redirect light passing through to provide the blended focus for each eye.
Once the cornea has been sculpted, the corneal flap is repositioned and the eye allowed to heal. Patients are given a protective eye shield, medicated eye drops, and post-operative care instructions. The ophthalmologist is likely to perform at least a couple of review examinations to ensure the eye is healing as expected.
Patients who undergo Presbyond laser blended vision treatment often find their vision is significantly improved for both distance and near just one or two days after surgery. Vision continues to improve and stabilise over the following weeks, resulting in a greatly reduced dependency on glasses and contact lenses for all activities.
Patients experiencing the inconvenient effects of presbyopia are welcome to book their complimentary initial consultation with Eye Laser Specialists. Book today by calling us 1300 297 583 or arranging an appointment online.
Note: Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.