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Medical Forum / General / Vision / September 2005Any presbyopia Lasik treatment?
Is there any surgery that helps presbyopia? I heard a few years ago they were working on something. try fasting, taking Bilberry plus Vitamin A, and use plus lens reader 24/7 > try fasting, taking Bilberry plus Vitamin A, and use plus lens reader > 24/7 :) Good one! Didn't anyone else read about this? Some sort of presbyopia lasik/surgery or something. Can you imagine what older people (with most of the world's money) would pay for something like that? Dear Georgeous, Subject: It is an ill wind that does not blow SOME good. I don't know how old your are, but the range of travel (stop-to-stop) just becomes less and less with age. For those who have had 20/20 up to 45 will find some slight blur at near -- thus the "plus" reader. If you are SLIGHTLY nearsighed, say pass the DMV with 20/40, you will keep you near vision perhaps to age 55. But that is the "price" of age. Best, Otis >Dear Georgeous, >Subject: It is an ill wind that does >not blow SOME good. I don't know what that means, but then: I never know what Otis means. Meanwhile, there are some new procedures, known as SRP (Surgical Reversal of Presbyopia) that may hold some promise: http://www.emedicine.com/oph/topic735.htm (You can use the terms "SRP" and "Surgical Reversal of Presbyopia" to do further online research). Others use a contact lens-based monovision arrangement (setting one eye for near work, the other for distance) with success. Still others use reading glasses. Not a lot of downside there ;-) > Dear Georgeous, > > Subject: It is an ill wind that does > not blow SOME good. The loss of focusing ability has no advantages. I've heard of people having, or at least considering, a Crystalens implant even though they did not have cataracts. But that hardly seems worth the risk and expense when a $10 pair of reading glasses will take care of the problem. Except when the presbyope also has significant hyperopia and/or astigmatism, both of which can be "taken care of" early, and eliminating the need for cataract surgery later in life. I'm not a fan of cristalens, rather prolate technis iols with slight mono result for those folks. w.stacy, o.d. > I've heard of people having, or at least considering, a Crystalens implant > even though they did not have cataracts. But that hardly seems worth the > risk and expense when a $10 pair of reading glasses will take care of the > problem. Clear lens exchange aka refractive lens exchange, works well for hyperopic presbyopia; for myopic presbyopia, monovision lasik is available, in which case I target plano for one eye and -1.00 for the other. Astigmatic corrections are available with either procedure. If you are already -1.00 in one eye, a monocular procedure is advised. w.stacy, o.d. > Is there any surgery that helps presbyopia? I heard a > few years ago they were working on something. The short answer is no. There is no surgery that can correct presbyopia. At best, there are techniques that can work around the problem, but they are limited. Of course reading glasses and bifocals are the most popular technique of dealing with presbyopia. Monovision is tolerated well by about 2/3rds of patients who try it and can be accomplished with contacts or refractive surgery. Removing the natural lens inside the eye and replacing it with a multifocal intraocular lens (IOL) is gaining popularity, but in the FDA trials about 20% of patients had halo and glare problems. The new Crystalens IOL is designed to change focus and restore accommodation, but the range is very limited and it does not work for everyone. Although there are still a few doctors who will do Surgical Reversal of Presbyopia with scleral implants or relaxation incisions, the science behind this is iffy at best, and results are just as iffy. Glenn Hagele Executive Director USAEyes.org "Consider and Choose With Confidence" Email to glenn dot hagele at usaeyes dot org http://www.USAEyes.org http://www.ComplicatedEyes.org I am not a doctor. Great answer. Thanks. > The short answer is no. There is no surgery that can correct > presbyopia. At best, there are techniques that can work around the [quoted text clipped - 29 lines] > > I am not a doctor. I'm glad to be of service. Sorry I didn't have the answer you were looking for, but it is better to know now than after surgery. Glenn Hagele Executive Director USAEyes.org "Consider and Choose With Confidence" Email to glenn dot hagele at usaeyes dot org http://www.USAEyes.org http://www.ComplicatedEyes.org I am not a doctor. I asked my opthamologist about this last week. He said it would be a mistake to screw with anything now. In about two years he thinks they will have a multifocal lense implant perfected, and it will be worth waiting for. > I asked my opthamologist about this last week. He said it would be a > mistake to screw with anything now. In about two years he thinks they > will have a multifocal lense implant perfected, and it will be worth > waiting for. That sounds interesting....any weblinks? It would probably be at something like www.WhenPigsFly.com The problem with multifocal anything is that the transition from one area of focality to another always causes light scatter. That light scatter can reduce contrast sensitivity, cause blur, and crate halos around light sources when you are in a low light environment. Sometimes even in bright light. Unless the physics of optics somehow change, all multifocal lenses are going to have these limitations, albeit at different amounts with different designs and with different levels of acceptance with different patients. The newest jump into the multifocal fray is the ReStor "apodized" IOL. The center of the IOL is multifocal while the mid-periphery and periphery is single focal. The theory is that when the pupils are large in low light environments, the single focal portion will contribute less halos and haze. Perhaps, but the FDA trials showed a 20% halo rate, and that is with excellent surgeons and very, very, very careful patient selection. Presbyopia correction has been the Holy Grail of refractive surgery for decades. Thus far everything that works at all comes with some compromise in vision quality. That may be perfectly fine for some (I use monovision) but totally unacceptable for others. Glenn Hagele Executive Director USAEyes.org "Consider and Choose With Confidence" Email to glenn dot hagele at usaeyes dot org http://www.USAEyes.org http://www.ComplicatedEyes.org I am not a doctor. |
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