For patients who have specific refractive defects, such as nearsightedness, LASIK is a common vision correction procedure that may help them see better. If you are looking for a solution that will allow you to get rid of your reading glasses, it makes sense to consider LASIK surgery. Can LASIK, on the other hand, genuinely fix presbyopia?
Is it possible to have LASIK done and have my need for reading glasses eliminated?
It is possible that LASIK will be a good option for people who are seeking treatment for nearsightedness or other common refractive errors. However, it is not intended to be used in the treatment of presbyopia. While LASIK works by reshaping the cornea, presbyopia, or the loss of close vision, occurs as a consequence of changes in the lens of the eye. Even if you had a surgery lasik treatment while you were in your 20s that allowed you to be free of glasses and contacts, you may still need reading glasses in your 40s or 50s. 2
Presbyopia can be treated by a procedure known as monovision LASIK, which is offered by some eye doctors. An example of this would be a monovision procedure, where one eye is corrected for distant vision and the other for close vision. Due to the fact that monovision is dependent on the brain’s capacity to adapt to it, it is not effective for everyone. After the age of 40, many patients also have dry eye symptoms, and LASIK has been reported to exacerbate dry eye symptoms in certain individuals. This off-label use of LASIK for the treatment of presbyopia is not approved by the FDA, and there is limited information on how effective it is in treating patients with presbyopia in this population.
Understanding the Causes of Age-Related Near Vision Impairment
As we grow older, the lens of the eye begins to stiffen and change shape, a natural process that causes a type of near vision loss known as presbyopia 1 to develop gradually. A common occurrence among people over the age of 40 is the tendency to hold items such as phones or books further away from their bodies or to squint when reading small print. Presbyopia is the most common cause of this difficulty in seeing things up close and personal. Although there is no way to avoid it, presbyopia affects everyone at some point in their lives. Reading glasses are the most popular therapy for it.
Treatments for Presbyopia are available.
The most frequent method of correcting presbyopia is using reading glasses. Many individuals, however, do not like the way they seem while they are wearing reading glasses, and they are bothered by the inconvenience of having to put their readers on and take them off during the day.
Exchange of Refractive Lenses (RLE)
The refractive lens exchange procedure (also known as RLE) is a type of vision correction procedure that is sometimes used to treat presbyopia. RLE is a procedure that includes replacing the natural lens of the eye with an artificial intraocular lens implant, using techniques that are basically the same as cataract surgery (IOL). Some kinds of premium IOLs, such as multifocal or trifocal lenses, may help to improve presbyopia and lessen the need for reading glasses in older patients.
The FDA has authorized intraocular lenses (IOLs) as a medical device for the treatment of cataracts, however they are not meant to be used to correct presbyopia as a main function. Since RLE is an off-label usage of IOLs, there is minimal evidence available. However, some specialists are concerned about postoperative side effects, which may vary from visual abnormalities such as halos and glare to more significant issues such as retinal detachment.
Are you over the age of 40 and finding it difficult to see tiny text with your glasses or lenses? LASIK is a procedure that may assist with this.
Modern LASIK surgery can correct reading vision problems caused by presbyopia using a technique known as monovision. In this procedure, the LASIK surgeon completely corrects the refractive errors in one eye while intentionally leaving the other eye mildly nearsighted, resulting in improved reading vision. As a consequence, the completely corrected eye sees far things extremely well, while the nearsighted eye gives better close vision without the need for reading glasses.
In most cases, if you are contemplating this option, it is best to first experiment with monovision using contact lenses for a short length of time to ensure that you can adjust to the monovision experience before going with monovision LASIK surgery.
Another alternative is multifocal LASIK, which is a surgery in which a laser is used to reshape the surface of the eye in a way that replicates the look of bifocal or multifocal contact lenses, respectively. The use of multifocal LASIK may lessen the need for reading glasses, but there is a higher risk of glare and halos following the treatment, which may be difficult to correct.
LASIK monovision is a procedure that may be used to enhance reading vision. Another option is a corneal inlay.
Another type of presbyopia correction surgery is corneal inlay surgery, which is a relatively new procedure. It is possible to perform this procedure using a laser to create a small pocket in the center of the cornea of one eye, and then place a small optical device (a corneal inlay or corneal implant) in this pocket, which then self-seals.
The corneal implant enhances the depth of focus in the treated eye, resulting in improved close vision while no substantial loss of far vision is experienced by the patient. For this reason, it is preferable to monovision LASIK, which improves near vision but causes significant blurring and distortion of distance vision in the “near” eye.
The Kamra corneal inlay is the only corneal inlay approved by the FDA for use in the United States to improve reading vision at this time (AcuFocus). A second corneal inlay, the Raindrop Near Vision Inlay (ReVision Optics), was approved by the FDA in 2016 but was subsequently withdrawn from the market in January 2018.
Another corneal inlay, the Presbia Flexivue Microlens (Presbia), has gained the CE mark, enabling it to be sold commercially across Europe; however, it has not yet been authorized for use in the United States by the Food and Drug Administration. [Learn more about corneal inlays in this article.]
In some cases, a corneal inlay procedure can be performed for people who have perfect distance vision without the use of corrective lenses and only require assistance with reading vision problems caused by presbyopia. Alternatively, it may be done at a later date following LASIK for those who need vision correction for nearsightedness, farsightedness, and/or astigmatism in addition to LASIK.
Finally, if you have been diagnosed with early cataracts (or if you are at high risk for developing cataracts as a result of your age or other factors), refractive lens exchange or early cataract surgery, which includes the implantation of a modern presbyopia-correcting intraocular lens (IOL), is an excellent option.
Due to the variety of alternatives available, it is recommended that you visit with your eye doctor to identify which surgical surgery to enhance your reading vision is the most appropriate for you.