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LASIK Options for Presbyopia - No More Bifocals!

Presbyopia Bifocals and Lasik What is Presbyopia
In order for us to see things clearly at various distances, the natural lens within each eye must change shape. As we get older, this lens stiffens, and our eyes lose their ability to focus on near objects. This is why many people 40 and older require reading glasses or bifocals.

Current Surgical Options
There are a number of surgical treatments currently available to treat presbyopia:

  • Monovision LASIK - This is for patients who are nearsighted as well as presbyopic. The surgeon corrects the nearsightedness in the patient's dominant eye, allowing them to use that eye to see distant objects clearly. The other eye is corrected for near vision. After surgery, the patient should no longer need their distance glasses or their reading glasses, however there are side effects, such as decreased depth perception. If you are interested in this treatment, you should try wearing monovision contact lenses first, to see how well you can tolerate monovision.

  • Laser Thermal Keratoplasty (LTK) - In this procedure, a laser is used to gently heat specific areas of the cornea. The heat causes collagen tissue to shrink, steeping the cornea and correcting the presbyopia.

  • Conductive Keratoplasty (CK) - Similar to LTK, but instead of a laser, this technique uses radiofrequency energy, delivered by a needle-like probe, to heat and shrink the tissue. One advantage of LTK is that no surgical instrument touches the eye during the procedure, however the effects tend to wear off over time, and the treatment does not last as long as CK.

Coming Soon: Multifocal LASIK
A new laser procedure to correct presbyopia is in the experimental stages. Called multifocal LASIK, or sometimes presby LASIK, it involves dividing the eye into different zones, each of which refracts light differently. After surgery, the patient can see distant objects clearly with certain areas of the eye, and close up objects with another area. This is similar to bifocal glasses.

For farsighted/presbyopic patients, doctors have determined that the procedure works best when the center of the cornea is corrected for near vision, and the periphery for distance. Researchers are still experimenting to determine the best configurations for these zones in patients who are nearsighted and presbyopic.

Multifocal LASIK has not yet gotten FDA approval, but studies have shown promising results, and this may become an option in the not-too-distant future.

Your eye doctor can give you more information on these and other treatments for presbyopia, and can help you choose the procedure that is right for you.

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