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Patient selection, preparation key to presbyopic treatment plan
For emmetropic presbyopic patients between 45 years and 60 years of age, Ioannis G. Pallikaris, MD, opts for corneal inlays due to the minimally invasive character of the technique and its reversibility. This option enables the surgeon to remove the implant when needed without tissue loss and replace it with another lens. Implantation of corneal inlays is an easy procedure for an experienced surgeon, lasting a few minutes, according to Dr. Pallikaris. Using a femtosecond laser with special software to create pockets simplifies the procedure further. Photoablation of the cornea is avoided, so there is no reduction of corneal thickness.
For ametropic patients between 40 years and 50 years of age, Dr. Pallikaris prefers corneal laser procedures, mostly monovision with a target of no more than 1.25 D to 1.50 D.
For emmetropic presbyopic patients older than 50 years, he chooses intraocular procedures with implantation of multifocal or monovision lenses. Besides the procedure itself, the most critical steps in the surgical treatment of presbyopia according to Dr. Pallikaris are appropriate patient selection, detailed explanation of possible outcomes and preoperative trial simulation of postoperative results using eyeglasses or contact lenses when possible.
- Disclosure: Dr. Pallikaris is medical director of Presbia.