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Presby LASIK

Presby LASIK is the newest laser vision correction surgery to reverse the natural loss of near focus due to age. Presby LASIK utilizes the excimer laser to correct both your near and distance vision. In this procedure, the laser is applied to each eye in the same way to give you binocular distance and binocular near vision. It is not a monovision correction; you don't need to have your brain "switch eyes" to focus.

In the past, LASIK was able to correct your distance vision only, thus those who needed reading glasses could not be “glasses free.” Now, Presby LASIK can give you the ability to see at all distances, eliminating the need for glasses while reading or enjoying leisure activities such as golf or sewing.

If you are a candidate for Presby LASIK and have reasonable expectations, the procedure can be added to your already planned LASIK surgical correction for distance.


Background

Presbyopia is the natural loss of near focus as you age, typically through your 40s. It results in the loss of accommodation of the natural lens inside your eye. The lens stiffens with age and loses the ability to change shape (accommodate). This results in a loss of magnifying power for near objects. Most patients who have normal distance vision find their “near world” blurry and need drugstore "readers" or "cheaters" to see again. Hyperopia (or farsightedness) as a result of aging typically starts with the individual needing a +1.50 correction to see up-close, and then typically progresses to a +3.0 correction as the aging process continues. If you have a need for distance correction as well, then the magnification for near can be ground into spectacles as a bifocal or progressive multifocal "add." Individuals may find they need bifocals or readers for common everyday tasks including:

  • Working at the computer.
  • Checking the time on your watch.
  • Text messaging on your cell phone.
  • Seeing the dashboard clearly in the car.
  • Reading the menu at a favorite restaurant or seeing ones food.
  • Reading the labels of food containers in the grocery store.
  • Quilting, knitting or sewing.
  • Leisure activities such as golf or tennis where both distance and near vision are necessary

Your typical presbyopic individual usually has multiple pairs of glasses to make sure they are adequately covered for their daily needs including having glasses in most rooms of the home, in the car, at work and possibly other locations. Reducing or eliminating the requirement for reading glasses in middle age provides tremendous day-to-day lifestyle convenience for all activities at near or intermediate range.


How the Procedure Works

The same state-of-the art excimer laser that has been used for the past 20 years to correct nearsighted, farsightedness or astigmatism is programmed to create multifocal zones in a ring around your pupil. This is done in each eye equally at the time of your LASIK surgery. In doing this, your cornea will be reshaped to maintain excellent distance acuity while increasing your depth of focus for near tasks. It does not create more haloes or starburst than the standard LASIK procedure.


Patient Expectations

Accuracy and dependence upon glasses

While the distance correction with LASIK is nearly 100% accurate, the near correction with Presby LASIK is approximately 77% effective at eliminating the need for readers. This means that you may still have to wear readers 23% of the time, or it may mean that 20% of the patients still have to wear glasses for near visual tasks. Typically, patients will still have difficulty when reading very fine print (e.g., stock quotes in the newspaper) or when attempting to read in dim light. The goal of Presby LASIK is to make you less dependent on reading glasses or bifocals. It is designed to help you become functional without glasses. You shouldn’t expect that you will see like you are 20 years old again, but most patients can read a book or newspapers, text message, read and write e-mails, surf the web, and read a menu without the need for glasses.

Recovery Time

It typically takes about 6-8 weeks for the eye to completely heal, thus revealing your best “near corrected” vision. Some patients have reported seeing perfectly at all distances right away, but most will need to wait longer for their eyes to heal completely before their near vision can go unaided.

Cost

If you are seeking only near vision correction, the standard LASIK price is applied. If, however, you are interested in both LASIK (to correct distance vision), and Presby LASIK (to correct near vision), the Presby LASIK procedure is priced as an “add-on” – only $300 per eye is added to the already quoted LASIK charge. Please contact us for our current LASIK pricing.


FAQ:

1. Can I get Presby LASIK if I’ve already had LASIK surgery in the past? Yes!

2. Can I see as well as my teenager to pull splinters from my finger? No, not likely.

3. Does it hurt or cause pain? No.

4. Will it compromise my distance vision? No.

5. What are the risks in Presby LASIK beyond those associated with standard LASIK?

It may not work as well as you had intended, and you may still need to wear reading glasses.

6. If the procedure doesn’t work as well as I’d hoped, can it be redone or touched-up?

Sometimes, depending upon several factors that Dr. Walter will happily discuss with you in detail.

7. Will there be an additional charge if a redo or touch-up can enhance my results? No.

8. How long does Presby LASIK last?

It should continue to enhance your reading vision well beyond your 60s. Once cataracts develop, there are premium lens implant options that can allow you to continue your non-reliance upon glasses.

9. Is there an age limit?

Dr. Walter has used the procedure on patients at age 65, with excellent results. In theory, the procedure should work at any age as long as there are no other eye diseases (such as cataracts) that might cause complications.

I’ve tried bifocal contacts and couldn't see with them, does that mean I won't like Presby LASIK?

Not necessarily. In general, patients who like bifocal contacts like Presby LASIK. However, we have had a few patients to do better with Presby LASIK than they did with bifocal contacts.