Presbyopia Correction Techniques

What is the current situation of presbyopia?

Surgical correction of presbyopia is currently one of the great challenges we have in refractive surgery. There are several reasons for this. One of them is the great frequency of this problem, we have to think that above 40 – 45 years of age everyone is affected by this problem to a greater or lesser degree. This means that approximately 37% of the Spanish population suffers limitations in their daily activities due to their dependence on glasses to be able to read, use a cell phone, computer or any activity that requires near vision. Another problem with eyestrain is its evolution, i.e., eyestrain gets progressively worse until approximately 60-65 years of age, so any solution we propose for this problem must focus on and correct not only the patient’s current eyestrain, but must also take into account this evolution and this progressive loss that the patient will suffer in the following years.

What surgical techniques can correct it?

Currently there are two techniques that have demonstrated their efficacy and safety for the treatment of presbyopia. Since 2009, we have been working on the development of the Presbylasik-Supracor laser technique, which is similar to the one we usually use for the correction of myopia, hyperopia or astigmatism, but in this case, advanced software allows us to sequentially apply a double treatment to achieve a bifocal effect on the cornea and, in this way, correct not only the distance defect but also the near defect and avoid the need for glasses for any distance. The second option we are using would be the substitution of the transparent crystalline lens by an intraocular lens, it is the operation similar to the one we are usually using for cataract surgery but what we do is to substitute the transparent crystalline lens by a Premium intraocular lens of multifocal or trifocal type of last generation that allows us to achieve a good focus at all distances.

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Can presbyopia be solved in all cases?

The fact that there are several surgical techniques for the treatment of presbyopia indicates the great complexity of this problem and that there is no universal technique that allows us to correct indiscriminately any patient, so we must be very selective when making this type of indications. It is very important to perform a complete ophthalmological examination of the patient to confirm that he/she is a suitable patient to undergo this type of intervention, but at the same time, other factors must be analyzed, such as, for example, the patient’s age, his/her job, his/her daily work activity, what his/her visual needs are for distance, middle distance and near vision and, in this way, the technique that will most effectively solve the problem of that particular patient can be selected.