Presbyopia and surgery

30 November 2018
Autumn 2018

How should optometrists tackle presbyopia solutions with patients, ask Georgina Wintersgill and Kieran Loft MCOptom.

Surgery to correct ametropia has traditionally been performed in three ways: on the cornea, within the cornea, or in the lens capsule. For presbyopic patients aiming for spectacle independence, there are three main options: (modified) monovision, multifocal (MF) or accommodation-restoring techniques.

Conductive keratoplasty and laser eye surgery are performed on the cornea. Laser eye surgery includes laser-assisted in situ keratomileusis (Lasik), small incision lenticule extraction (SMILE), and surface laser treatments such as laser-assisted subepithelial keratectomy (Lasek) and photorefractive keratectomy (PRK). Using laser to create an ‘MF corneal profile’ is a possible treatment paradigm for presbyopia, sometimes referred to as PresbyLasik. Different versions of this treatment show different levels of success, and long-term outcomes are still being collated (Vargas-Fragoso and Alio, 2017; Gil-Cazorla et al, 2016).

Sign in to continue

Forgotten password?
Register

Not already a member of the College?

Start enjoying the benefits of College membership today. Take a look at what the College can offer you and view our membership categories and rates.

Related further reading

Souleyman Bah, a contestant in The Apprentice has a rare eye condition called RP.

Souleyman Bah, a contestant on The Apprentice who was fired last night, has a rare eye condition called RP.

Our Clinical Adviser comments on the BBC story about gene therapy to treat inherited retinal dystrophies.