What is PresbyLASIK?

PresbyLASIK is used to treat presbyopia, the normal loss of natural lens flexibility in people over age 40. This is a new approach to shaping corneas. This technique creates concentric zones of focus similar to multifocal contact lenses.

This procedure is also called Multifocal Lasik, Bifocal Lasik, or Lasik for Presbyopia. This procedure has been used in other countries successfully for several years, but is still being tested in clinical trials in the U.S.

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How Does Work?

PresbyLASIK adapts laser eye surgery techniques to shaping the cornea into the same design used for multifocal lenses. Multifocal lenses have been used successfully to replace natural lenses for people with cataracts.

Each circular step of a multifocal lens has different focusing power providing clear vision in near, mid-range, and far distances. When you look through a lens shaped this way you can see clearly at all distances because you direct your attention to the area of clearest vision.

There are three approaches to sculpting the cornea. Your surgeon may prefer to make the central zone focus for either distance or near vision.

Whichever he chooses, the next larger area will be sculpted to give clear intermediate vision. Finally, he will shape the outer zone for the opposite range of focus than the center zone.

Eye surgeons who prefer the distance vision in the center claim that this technique leaves them an easy way to correct to monofocal distance correction if it is needed.

Those who prefer to shape the center of the cornea for near vision believe that those patients experience fewer aberrations and less need for reading glasses.

Modified monovision is the third option. Your surgeon may recommend that your non-dominant eye be shaped for multifocal vision, and your dominant eye be corrected for distant vision. This is a combination of multifocal and monofocal correction.

Pros and Cons

  • the results of three different clinical trials indicate that all patients were free of corrective lenses, and in two trials patients’ vision was between 20/20 and 20/25.

  • about 10% of patients need a follow-up treatment.

  • multifocal treatment in one eye may provide clearer distance vision than in both eyes.

  • modified monovison adds an intermediate range that is absent in monofocal correction of both eyes.

  • reversal is easier if the central zone is shaped for distance than for near vision.

  • the need for cataract surgery after PresbyLASIK may complicate the selection of the right power lens.

    • PresbyLASIK is indicated if you:

  • have presbyopia

  • have nearsightedness, farsightedness or astigmatism correctable by laser eye surgery

    • PresbyLASIK is not indicated if you:

  • engage in hobbies or professional activities that are rough or pose risk of hitting eyes

  • have prior eye injury that would prevent successful outcomes or increase risk

  • have dry eye
    •
  • have had lens prescription changes within two years

  • have cataracts

  • have glaucoma

  • are pregnant or nursing (lactating)

  • have corneal scarring

  • have autoimmune disorders

  • are taking steroids or immunosuppressants

  • have eye disease or abnormalities that will slow healing such as:

  • diabetic retinopathy
    •

  • ocular hypertension
    •

  • autoimmune disorders

  • Herpes simplex of the eye
    •

  • hypertension

  • have keratoconus (irregularity in dome shape of the cornea)
    •

    Associated Risk

    This surgery has risks that are similar to other laser eye surgery procedures. Though rare, the ones that occur most often include:

  • reduced contrast sensitivity for three to six months

  • over- or under-corrections

  • halos or starbursts around lights

  • dry eye

  • infection

  • corneal scarring

  • eyelid droop
    •

  • chronic discomfort

  • blurry distance vision after surgery may not clear up

  • possible intolerance of contact lenses (sometimes needed if additional correction is required)

  • vision may decline with age, requiring future surgical treatment

    • Return From PresbyLasik To Laser Eye Surgery

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