Before laser correction of presbyopia became a popular refractive surgery procedure, generations of Poles struggling with visual impairment (myopia, hyperopia, astigmatism) and presbyopia – commonly referred to as senile farsightedness, while in medical nomenclature presbyopia (presbyopia) – had no choice but to stock up on two pairs of glasses. The former had to correct a visual defect, while the latter was used for reading.

A significant advance was the advent of bifocal eyeglasses, that is, eyeglasses in which two powers are built in – in the main area (when looking straight ahead) the power for seeing at a distance, and in its lower segment – a higher power to facilitate reading. However, the transition from one area to the other is very unnatural for the eye, taking place in leaps and bounds, and not every patient was able to get used to wearing bifocal glasses.

So progressive glasses were created. With progressive glasses, the change of the corrective value on the surface of the lens is made not in leaps and bounds, but smoothly. The upper part of the corrective glass is used to see objects far away, lower its power increases so that you can see intermediate distances (from a few meters to a few tens of centimeters) sharply. The lower area is for reading and looking at a distance of less than half a meter. Progressive glasses can also have lenses that correct other vision defects.

And finally, the proliferation of laser correction of presbyopia has meant that thanks to the procedure, just a few days after the operation, the patient regains good vision and no longer needs to use glasses.


Presbyopia
, which is important to remember, is not a defect of vision, but a set of physiological changes that occur with age in the human eye. They cannot be prevented or inhibited: our eyes “wear out” and we have no control over this. As with all laser vision correction procedures, the results of laser surgery for presbyopia are permanent and the procedure rarely needs to be repeated. Presbyopia happens in the lens and we are correcting the cornea, also after years there is a probability of “refining the defect” do not forget that we are correcting a tissue and not a piece of plastic.

Two different lasers are used in laser correction of presbyopia, allowing the wearer to dispense with glasses:

  • The femtosecond laser makes a small incision in the cornea.
  • The excimer laser “sets” the dominant eye to have good vision for distance, while the other eye is set to have myopia between -0.5 and -1.5 diopters, and they add so-called “myopia”. spherical aberrations. Such parameters guarantee the least restriction of spatial vision. Of course, there are significant differences in the needs of near and far vision on a case-by-case basis.

If the patient does not have a refractive error and their only issue is presbyopia, they have the following options for laser correction of presbyopia

  • Femto-LASIK
  • PresbyMAX monovision, so called. blended vision (we need to describe this in a separate article)
  • lens replacement, phakic lens

If presbyopia is accompanied by a visual defect, the patient has the following laser correction methods to choose from:

 

The least invasive and resulting in the fewest possible complications method of laser correction of presbyopia and laser correction of presbyopia with comorbidities is Femto-Lasik in combination with PresbyMAX / Presbyond / Supracore presbyopic profile. At our clinic we use the Presbymax profile because of the excellent results we have seen over the years…. This is the most individualized profile for laser vision correction in the case of presbyopia with coexisting vision defects (ranging from -7.0 diopters to +3 diopters and up to 4.0 cylinders) or without these defects, which is conditional on the patient’s own lens being transparent. The PresbyMAX method belongs to the Laser Blended Vision (LBV) group of treatments, the essence of which is to increase the depth of field for each eye through the use of an original nonlinear and aspherical laser ablation profile. LBV treatments do not impair the quality of vision and are much better tolerated than traditional monovision. LBV treatments with micromonovision (the near eye has up to -0.75 diopter) involve harmoniously adjusting the vision of the eyes to produce sharp images for distance, near and intermediate distances. The undoubted advantage of these methods is the preservation of spatial vision (stereopsis) with minimal side effects when looking to the distance compared to the popularly used monovision. LBV methods are well tolerated by 97% of patients Laser correction of presbyopia is a painless, short procedure – including preparation it takes up to 20 minutes, with the laser interference itself being just a few minutes – and causes no pain. Laser correction of pres byopia is a procedure that is as safe as possible. The number of complications is less than 1% of cases. For any medical procedure, the term “guarantee” is not used, but “effectiveness of the procedure.” The laser vision correction procedure is effective in approx.

95%.