Surgical presbyopia solutions

Presbyopia is an eye problem that is very common among people over 40. While most doctors consider stiffening of the lens as the cause of presbyopia, some others believe other reasons such as continued growth of the lens and atrophy of lens muscles. Traditional solutions to this bothersome eye problem include reading glasses and multifocal lenses. Thanks to modern surgical advancements, there are several types of surgeries that can be used to correct presbyopia, either FDA-approved or investigational.

Monovision LASIK for nearsightedness correction

The technology of monovision can be applied to LASIK, during which the non-dominant eye is leaved slightly nearsighted in order to get better near vision in presbyopic people. In similar, this way requires a prior test of adaption to monovision at the patient’s side. Monovision LASIK is usually used to correct nearsightedness. But it is actually feasible to deal with hyperopia in a similar just by reshaping the dominant eye for near vision. Before the approval of monovision LASIK in 2007, most doctors took use of contact lenses to create the effect of monovision. Monovision contacts fit the dominant eye for distance vision and the other for close vision.

Monovision Conductive Keratoplasty for farsightedness correction

Monovision can also be combined with Conductive Keratoplasty (CK), which uses low-level, controlled radio energy to steepen the central cornea. Received FDA approval in 2004, CK is now typically performed to correct farsightedness. Applying monovision, surgeons of CK only correct one eye for near vision and leave the other one untouched for distance vision. Minimally invasive, monovision CK may bring tearing, foreign-body sensation or vision fluctuation. Laser thermal keratoplasty (LTK) is almost the same as CK. The single difference lies in that LTK uses mild laser, rather than radio energy.

PresbyLASIK for presbyopia correction

Both of the above surgeries only create single-vision eyes or more exactly natural eyes. By forcing one eye to perform near visual tasks and the other for distance objects, monovision surgeries do act as a solution to presbyopia correction. The problem is that a quite large portion of patients can not adapt to this monovision effect. All in all, the two eyes are not naturally coordinated. There is another option for this group of people. Also known as presbyLASIK, investigational multifocal LASIK creates different visual zones on the cornea. Just like multifocal contact lenses, the reshaped cornea can offer clear vision at all distances.

Replace the damaged natural lens an artificial one

Another surgical treatment for presbyopia named Refractive Lens Exchange (RLE) is a more thorough solution. The surgeon will remove the patient’s damaged natural lens and insert an artificial one. Even if it is only used off label for qualified candidates, RLE is more and more popular among presbyopic patients. Corneal inlays that are under clinical experiments also aim at correcting presbyopia.

Surgical Reversal of Presbyopia under experiment

Another surgery named Surgical Reversal of Presbyopia (SEP) involves the insertion of Scleral Expansion Bands (SEBs) that are made of polymethyl methacrylate. In a SEP, four SEBs will be inserted below the surface of sclera, increasing the distance between the lens and its muscles. This new solution to presbyopia is still experimental.