Brussels Eye Center

PRESBYOPIA : Laser and Multifocal Implants

Presbyopia is an age-related progressive loss of the focusing power of the lens. This results in blurry close vision. The focusing power of the lens, which depends upon the inherent elasticity of the lens, is gradually lost as people age. Symptoms occur generally around the forties.

This results in a slow decrease in the ability of the eye to focus on objects nearby.

Presbyopia is a natural evolution of the aging process and affects everyone :

  • Monovision and combined vision : Using PRK or Lasik surgery for myopia and hyperopia, and inducing a small degree of myopia on the dominated eye allows a comfortable close-up vision, while the dominating eye is corrected for far vision.
  • Presby-Lasik : Lasik surgery that combines hyperopia correction for far vision and presbyopia for close vision on a second corneal focal. Visual outcome is usually 0.7 to 0.8 for far vision and 0.9 to 1.0 for close vision.
  • PresbyMax : this is a treatment incorporated into the Schwind Amaris laser that allows computer-assisted treatment of presbyopia associated with myopia, hyperopia or astigmatism by creating a corneal multifocality that provides distance and near vision without correction. This technique is reversible in case of disturbing night-time visual disturbances.

This treatment module is ideal for the safe and effective treatment of patients with myopia, hyperopia, or astigmatism with presbyopia. PresbyMAX is based on a bi-aspheric and multifocal corneal ablation profile.

  • Corneal Inlays Placement of an intra-corneal device in the non-dominant eye, allowing close vision without glasses by pinhole effect or focusing through a small hole (KAMRA technique) or by refractive effect. This technique is reversible by removing the device in case of intolerance or poor visual quality.
  • PRELEX (Presbyopic Lens exchange): Extraction by phacoemulsification of the opacified lens and insertion of a multi-focal or accommodative artificial lens, allowing far vision and near vision without glasses in 80% to 90% of cases. In 10% to 20% of cases, glasses are needed for reading small characters in near vision. Limits and complications of PRELEX are similar to cataract surgery.

Multi-focal or accommodative artificial lens :