PRESBYOPIA AND VISION CORRECTION
LASIK and Refractive Lens Exchange - As we age, the natural lens of the eye becomes less flexible. It's that flexibility that allows your eyes to see both UP CLOSE and AT A DISTANCE. If you are over 40, you are probably beginning to have trouble reading small print unless you hold it at arms length! This condition, known as presbyopia, usually begins around the age of 40, and is most often corrected by using glasses or special contact lenses. The good news is that presbyopia can be corrected with LASIK and Refractive Lens Exchange surgery. However, it is very important that you fully understand these two options before you make any decision about eye surgery.
Until recently, life without reading glasses or bifocals was not an option for those who reach a certain age or for most cataract patients. But now, VisionFirst is able to offer patients over 40 a choice between LASIK and refractive lens exchange, using multifocal or accommodative lens implant. These refractive lens exchange implants provide excellent vision not only for patients who need cataract surgery, but also for people with presbyopia over the age of 45. These two options are discussed in detail below.
If you have presbyopia, here are two options to consider: LASIK or Refractive Lens Exchange
REFRACTIVE LENS EXCHANGE
Refractive Lens Exchange (RLE) is a procedure for patients over the age of 45 who want to reduce their dependence on reading glasses. Using the same procedure that has been used for millions of patients undergoing cataract surgery, Dr. Mark Bearman and Dr. Sarah Hays perform the RLE procedure by removing the eye's natural lens and replacing it with an artificial lens implant. With the RLE procedure, specially designed intraocular lenses are used that allow the eye to focus for distance and NEAR. For more information about the various RLE lens implants, click on the links provided below:
- The ReSTOR® (www.acrysofrestor.com)
- The Tecnis MultiFocal® (www.tecnismultifocal.com)
- The ReZoom™ (www.rezoom.com) and
- The Crystalens® (www.crystalens.com)
Even though the RLE and cataract surgical procedures are the same, the reasons for performing the surgery are different. While cataract surgery is done to remove a patient's cloudy lens, RLE is used to correct presbyopia AND distance vision, and hopefully reduce or eliminate a person's dependence on glasses or contact lenses.
REFRACTIVE LENS EXCHANGE is used for the following types of patients:
• Patients with very high levels of nearsightedness or farsightedness.
• Patients who want to limit their dependence on bifocals or reading glasses.
• Patients who have corneas that are too thin for LASIK.
• Patients who may be showing signs (even without symptoms) of developing cataracts.
How Can You Benefit from REFRACTIVE LENS EXCHANGE?
• Improved DISTANCE vision (no glasses needed for driving in over 99% of patients).
• Improved NEAR vision (results depend on the type of lens implant selected)
• Prevention of cataracts - the artificial lens means you will never develop a cataract!
• FDA data shows that following RLE surgery with the Alcon RESTOR intraocular lens:
80% of patients never wore glasses
17% of patients sometimes wore glasses
LASIK MONOVISION
Monovision LASIK has been used for a long time as a form of treatment for presbyopia. In monovision LASIK, one eye is corrected for DISTANCE vision, while the other is corrected for NEAR vision. In most cases, the brain adapts, and vision at both distance and near is improved.
But remember, this situation is a compromise. It does not eliminate presbyopia, but improves it. Distance vision is not perfect, but good. Near vision is not perfect, but good enough to function. Monovision will allow someone with presbyopia to read a label, tell the time on his or her watch, shave in the mirror, or read a menu in the restaurant. Very fine detailed near tasks will still require reading glasses, as well as prolonged near tasks such as reading a book for several hours. Eventually with age, almost everybody will still require reading glasses for up close tasks.
It may take two to three weeks for the brain to adjust to Monovision. Some people love it; others cannot tolerate the imbalance between the two eyes. Monovision should first be tried in contact lenses, before it is made permanent with laser treatment.
Disadvantages of Monovision:
• Decreased depth perception, particularly for sports, like hunting and golf.
• Reading very fine print or reading for long periods of time will still require reading glasses.
• Driving long distances at night may be more difficult. (This can be overcome by wearing prescription eyeglasses with a lens that corrects the NEAR eye to distnce for driving.)
Monovision LASIK and Refractive Lens Exchange are great vision correction options, but must be fully understood before you make any decisions about surgery. Our doctors can help you decide the best option available to help reduce your dependence on eyeglasses. Call us at 205-941-2020 for more information.
Cataracts and Astigmatism, Gone—AcrySof® Toric Lens
If you have astigmatism, you know how difficult it can be to see well, even with eyeglasses or contact lenses. The good news is that LASIK surgery can treat astigmatism. But, if you are planning to have surgery to remove a cataract, or if you are not a candidate for LASIK, you now have an additional option: an implantable lens that makes it possible to treat the cataract and correct the astigmatism at the same time. The AcrySof® Toric intraocular lens makes it possible to reduce or eliminate corneal astigmatism and significantly improve your DISTANCE vision, without eyeglasses and contact lenses.
