Reading glasses correction
As of the age of 40 our own eye lens becomes less elastic which causes reading issues. This phenomenon is called Presbyopia. Luckily there are both modern and permanent solutions for this problem. The described treatments are suitable for people of age 40-60.
What are the surgical solutions?
- Lens implantation Prelex (presbyopic lens exhange): The still unclouded lens of the patient is substituted by an implant lens. Vision for far is corrected by this as well as vision for PC and nearby. With the trifocal implant lens, one reaches a focal point for distance, for PC and for close-by. Some patients complain temporary of halo’s around the traffic lights at night
- Excimer laser can also be proposed. Laserblended vision(LBV) laser correction creates a laser ablation profile by which a distance and close-by correction are applied simultaneously. Both eyes are treated. Patients receive a better depth focus and the stereo vision is conserved. Post-LBV night vision can sometimes be a bit disturbed.
- Corneal inlay (vue+ and kamra inlay or acufocus) : After creating a femtolaser corneaflap, only the reading eye receives a miniature contact lens (2mm cross-cut and 30µm thickness) in it’s cornea which makes the patient able to read normally again. This is the only reversible technique. Some patients notice a slightly lower farsight vision at the operated eye and seldomly some halo’s can occur around the lights of oncoming traffic.
What are the advantages and disadvantages of these techniques?
- LENS: lens implantation requires very detailed preparational measurements. After implanting an intraocular lens it may occur that the refraction for far isn’t exactly plano. In these few cases there will be need for a extra lasik correction to arrive at plano. Lens implantation is a permanent solution for presbyopia. Although we only implement a lens replacement with people passed the age of 50. Also the results are optimal with patients suffering from farsightedness. After some years, secondary cataract may occur, which we can treat with the Yag-laser. Trifocal lenses have built-in concentric circles which can cause halo’s or glare around the lights of oncoming traffic for the patient. These complaints decline considerably in the first few months, mainly due to the phenomenon of neuroadaptation of the brain. With the trifocal lens though, one can read the smallest letters uncomplicated and work at the PC.
- The excimer lasercorrection with LBV can also cause a slight halo, though LBV conserves stereo vison and a increased depth of field. Night vision often suffers a minor drawback. This technique postpones wearing reading glasses.
- Corneal inlay can cause some halo’s. This technique is the only reversible one and applies to one eye only. The patient will no longer need reading glasses permanently. At a higher age one can remove this lens before opting for cataract surgery with trifocal lens implantation.
By selecting a team of able and competent doctors and a modern, specialized clinic you reduce the risks as considerably.
What determines the choice between laser or lens replacement?
Lasering (LBV) or the inlays are mostly recommended to the young presbyopian.
Lens replacement is a somewhat more drastic intervention with a lens implanted into the eye. After all, one can never fully rule out the risk of infection. The lens replacement is certainly recommended in case the lens is already showing signs of cataract, something which we notice a lot with patients aged 60. According to your proffesional situation or hobby, one type of treatment can be chosen. For example, an elder patient who does no longer drive a vehicle but is active at sewing will rather more than less receive a trifocal lens and with an active driver a modified refractive lens will be reccomended.
