Presbyopia – the unavoidable age related condition that affects everyones near vision at some point in their lives. Usually after your 40th birthday, it becomes increasingly difficult to see up-close objects and text, with more than 60 million people in the United States facing this condition. As of now, your vision correction options are limited to glasses, contact lenses or monovision LASIK – where one eye sees better far away and the other sees better up close.
However, there are new procedures, currently gaining popularity in Europe, that look promising to help with your near vision in the future.
A Corneal Lens Implant with Built-In Vision Correction
The Flexivue lens is an extremely thin lens that is inserted into the cornea of the patient’s non-dominant eye through a tiny pocket made with a highly precise laser. After the lens is inserted, the pocket self-seals and holds the lens in place. The treated eye’s near vision improved significantly without glasses; however, the distance vision did decrease a bit in the treated eye.
“This corneal lens implant appears to be a safe [and] effective way to correct presbyopia in people aged 45 to 60,” said Dr. Ioannis G. Pallikaris. “Ninety-eight percent of patients were satisfied with their vision; 69 percent reported ‘excellent’ and 30 percent ‘good’ near vision in our survey. Ninety-two percent said they no longer used glasses.”
Dr. Pallikarissaid added that there were no surgery-related complications and a key advantage is that, unlike LASIK and related refractive surgical procedures, the effects of corneal lens implants can be reversed by lens removal.
Corneal Inlay “Pinhole” Optics Sharpens Near Vision
Corneal inlays work by changing the eye’s depth of focus. The procedure involves making a corneal flap just like in LASIK, then placing a small, donut-shaped inlay in the center of the cornea of the non-dominant eye and replacing the flap. The inlay’s small opening creates a “pinhole” effect by blocking peripheral light coming into the eye – which ultimately results in improved near vision. Distance vision is mostly unaffected, but patients may notice a slight difference when they compare their two eyes. Like corneal lenses, inlays’ effects can be reversed by removal.
“Results for AcuFocus have remained stable for three years of follow up, and we’ve seen dramatic improvements in corneal inlays in the past seven years of clinical study,” Dr. Durrie said.
Reshaping the Cornea without Breaking the Surface
Perhaps the most surprising cornea-based correction technique among the newcomers is INTRACOR. This technology applies fast laser energy pulses inside the cornea without removing tissue. The pulses cause a biomechanical change in the cornea that shifts its center slightly forward and improves near vision while maintaining distance vision. Small incisions may also be made to correct a small degreesof near- or farsightedness. The procedure, done in the non-dominant eye, takes less than half a minute.
Mike P Holzer, MD, presented two year follow-up data on INTRACOR presbyopia correction in 25 patients. Participants showed significant gains in near vision without glasses and maintained good distance vision. INTRACOR has generated strong interest in Europe, Asia and South America and is gathering momentum in the U.S.
“The procedure is painless, and because no tissue is removed, the risk of infection is extremely low and the body does not need to mount a strong healing response,” Prof. Holzer said. “The cornea is not weakened, as it can be with other types of refractive surgery. Patients’ vision improved within hours of the procedure and remained stable over the follow-up period,” he added.
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