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PUBLICATION EXCLUSIVE: Presbyopia treatment in 2017: Where are we?
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In this edition of Ocular Surgery News, the OSN Roundtable discusses how presbyopia is becoming a subspecialty of ophthalmology. In this guest commentary, Francesco Carones, MD, weighs in on the topic
Looking at the present state of refractive surgery, in which the correction of refractive errors such as myopia, hyperopia and astigmatism has become safe, accurate and precise with outstanding results for most patients, I feel that presbyopia correction still involves challenges and compromises. Think of the procedures we use to correct, let’s say, 2 D of myopia. I can count three, maybe four, surgical techniques that are currently used — LASIK, PRK, advanced surface ablation, SMILE — and all of them provide similar, excellent results. Think now of the procedures we use to correct the same amount of presbyopia, 2 D. I can count at least 10 different approaches, and none of them gives the same results. This, however, does not mean that presbyopia cannot be safely and successfully corrected. It means that each single approach has potential advantages but also downsides leading to compromises, and our challenge as surgeons is to identify for each single patient what is the best acceptable combination between advantages and compromises.
The cover story in this issue of Ocular Surgery News presents a round table on presbyopia correction, which gives me the opportunity to focus on the current and future approaches to treat presbyopia without removing the crystalline lens and implanting a multifocal IOL, which, in my opinion, represents the best option today.
Let’s start from monovision (one eye plano, the other one –1.5 D). It can be obtained through several different surgical procedures, although it is commonly delivered with laser treatments. It is extremely safe, and it can be reversed, even with spectacles. These are the greatest advantages. On the other hand, it works better in younger patients, and it is monovision. This means that the two eyes perform differently, with some loss of stereoacuity, which is not what patients would like to have should a better option be available. Spectacle independence relies also on the eye’s residual accommodation, being better performing in younger patients than older patients.
- Click here to read the full publication exclusive, Guest Commentary, published in Ocular Surgery News U.S. Edition, April 25, 2017.