Laser Presbyopia Surgery
Reviewed by: Dr. David Evans
If you are over the age of 40, your near vision probably isn’t quite what it used to be. Bifocal contacts and glasses remain a safe and effective way to see clearly despite your presbyopia. But perhaps your bifocal contacts are no longer working for you in places such as dark restaurants, and you’re tired of having to lug your reading glasses with you.
Luckily, a broad spectrum of treatments is available to correct your age-related farsightedness (presbyopia), from advanced laser surgery to artificial lens-based procedures. Many of these procedures can correct your presbyopia and conditions like nearsightedness and astigmatism at the same time. The various laser correction options are described below.
Why Opt for Laser Correction?
In addition to correcting your age-related farsightedness and other refractive errors, laser presbyopia surgery has all the benefits of other laser vision correction procedures, including:
- Quick procedure time
- Fast recovery
- Little pain or discomfort (though the PRK or epi-LASIK versions of the procedure may cause more discomfort than the LASIK version)
- Reduced need for reading glasses
- Affordability (about $2,000 per eye; ask about financing options)
To be eligible fyou must have presbyopia and meet the requirements of other laser vision correction procedures. For example, you must be at least 21 years of age, with stable vision and no history of eye disease. It is also very important that you have realistic expectations of the results. Finally, if you have had procedures involving the insertion of an artificial lens, such as refractive lens exchange (RLE), you are not a good candidate for laser presbyopia surgery.
Types of Laser Presbyopia Correction
Monovision laser surgery. Sometimes called “blended vision,” this is the most popular of the three laser presbyopia procedures. During the procedure, your surgeon will correct one eye for distance vision while intentionally leaving the other mildly nearsighted to reduce your need for reading glasses. It’s a good idea to try monovision with contact lenses before having monovision laser surgery, to make sure that it works well for you.
Multifocal laser surgery. During this procedure your surgeon creates concentric rings in your cornea to correct your distance or near vision so that you can see at multiple distances. This is a great option if you have used and liked multifocal contact lenses, but now want to rid yourself of the lenses. There are many types of multifocal laser surgery; the procedure is tailored to your individual vision needs. Sometimes referred to as PresbyLASIK, this multifocal laser surgery is not yet available in the U.S. However, it has been performed abroad with success for years.
IntraCor laser surgery. This is a new procedure and, like multifocal laser surgery, is not available in the U.S. at this time. IntraCor changes the shape of your eye’s cornea to increase the magnifying power of your eye. This procedure is performed inside the eye, so unlike many laser vision correction procedures, there is no cornea flap or vaporization of tissue involved. As a result, certain potential complications associated with these processes are eliminated.
Risks & Complications
Multifocal and monovision laser surgery share certain potential risks with other forms of laser vision correction, including:
- Glare and/or halos around lights
- Dry eye
- Reduced quality of vision
If you have monovision laser surgery, you may experience blurred binocular vision, especially at night or in low light. It is also possible your eyes will lack the necessary magnification power to read small print. As a result, it is important that you test out monovision with contact lenses before having monovision laser surgery.
How Much Does Laser Presbyopia Surgery Cost?
Laser presbyopia surgeries are generally similar in price to other laser vision correction surgeries. The cost will vary based on the reputation and location of your surgeon, and on the technologies he or she uses. The surgery will likely cost about $2,000 or more per eye. If you feel you can’t afford it, make sure to speak to your surgeon about patient financing; there are a number of financing options available.
Other Surgical Options
There are also several non-laser treatments that can correct your presbyopia and other vision problems in one procedure.
Conductive Keratoplasty (CK). During this procedure, your surgeon uses a handheld probe that sends radiofrequency waves to multiple locations on the outside of your cornea. This shrinks the affected tissue and increases the curvature of your cornea to improve your near vision. CK is usually performed on one eye.
Corneal Implants. These miniscule artificial lenses are implanted inside your cornea, altering its shape to improve your reading vision.
Refractive Cataract Surgery. If you have cataracts that need to be removed, this option lets you correct your presbyopia at the same time. There are many different lenses available to suit your individual needs.
Refractive Lens Exchange (RLE). Employing the same technique used in refractive cataract surgery, this procedure removes your natural lens and replaces it with an artificial lens. The only difference is that the lens removed isn’t cloudy (or “cataractous”).
To learn more about the options available to correct your presbyopia, speak with a qualified eye surgeon in your area.