Dr TC Botha Ophthalmologist - Presbyopic LASIK

PRESBYOPIC LASIK SURGERY

Presbyopic LASIK is a type of laser eye surgery that can correct presbyopia, a common age-related condition that causes difficulty focusing on objects close up. Unlike traditional LASIK, which focuses on correcting nearsightedness and farsightedness, Presbyopic LASIK is designed to treat presbyopia.

During the procedure, a laser is used to reshape the cornea in order to improve the eye's ability to focus on near objects. The procedure usually takes around 15 minutes, and most patients experience improved vision within a few days.

WHAT IS PRESBYOPIA?

Presbyopia is a condition that occurs naturally with age, and is characterized by difficulty focusing on close objects. It is caused by a decrease in the flexibility of the lens of the eye, which reduces the ability of the eye to change focus.

Symptoms of presbyopia include difficulty focusing on close objects and needing to hold objects at arm's length to focus on them.

Treatment options include corrective lenses (reading glasses or contact lenses) and refractive surgery.

TECHNIQUES USED IN PRESBYOPIC LASIK SURGERY:

Certain techniques are utilized to give a non-accommodating patient both near and distance correction. In the young normal eye, the human lens moves. Unfortunately, there is currently no technology available to simulate this movement and remain clear.

The pristine cornea has no aberrations, but with some of the techniques surgeons use aberrations to give extended depth of field. With other techniques, the combination of the two eyes are used to give both near and distance correction; i.e. one for near, the other for distance. These techniques can also be combined.

Monovision

The dominant eye is used for distance, while the non-dominant eye is used for near. As the cornea is lasered for a single focus point, the visual quality per eye is excellent/normal. The drawback to this technique is that the two eyes do not focus together. Some patients tolerate this scenario very well in the fact that they do not even notice that the two eyes are different they just use the eyes at all focus distances together, while others do not tolerate it at all. A contact lens trial is sometimes used before the procedure by your optometrist to determine whether you will adapt to this scenario. For the patient that adapts to the fact that the two eyes are different, this is option number one as it achieves the best quality of vision with both eyes open.

µ-Monovision

The dominant eye is used for distance, while the non-dominant eye is used for intermediate to near. It is different to pure monovision in that the non-dominant eye is set for an intermediate distance, meaning very fine print is not seen, and a reader’s spectacle is still necessary for this. But bigger print (e.g. cellphone, menu in a restaurant, newspaper and dashboard in a car while driving) should be visible. Once again, because the cornea has very little aberrations, the quality of vision is excellent. Most patients can adapt to this scenario quite easily because the two eyes’ focus point is very close to each other and even overlap. A contact lens trial is not necessary. If one does not adapt well, then the procedure is easily reversible.

PresbyMax

This technique lasers the cornea into such a shape that there is extended depth of focus. Corneal aberrations give the patient extended depth of focus per eye. Combining this technique with the options above, one can give total depth of view from distance to near. The Schwind Amaris is the only laser with the formulae to perform the PresbyMax procedure. Other laser platforms use other profiles with similar effects.

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