WHAT IS PRESBYOPIA?
PRESBYOPIA TREATMENT OPTIONS
- Reading Glasses or Progressive Spectacles The simplest presbyopia treatment option is to use reading glasses or progressive spectacles. However, not everyone likes wearing spectacles. Spectacles can be easily misplaced, uncomfortable for the wearer, and aesthetically unappealing.
- Monovision or Multifocal Contact Lenses For those who do not want to wear spectacles, monovision or multifocal contact lenses may help. However, some may not be able to use contact lenses. The use of contact lenses can also be inconvenient and might be associated with certain contact lens-related risks like infection, dry eyes and allergies.
- Surgical Options Currently, there are a number of presbyopia treatment surgery options available and they include the following:
Monovision with various refractive surgery options
Monovision involves correcting the dominant eye to see distant objects and correcting the non-dominant eye to see nearby objects. The aim is to allow the patient to be spectacle independent for most daily activities.
This can be achieved by different presbyopia surgery options. Laser refractive surgery by LASIK, SMILE or advanced surface ablation can be used to achieve monovision. Implantable collamer lens (ICL) surgery is another available option that can be performed to achieve monovision.
Cataract surgery with specialised intraocular lens
Cataract is an age-related eye condition which can affect an individual’s vision. However, cataract surgery with intraocular lens implantation can correct this condition. Currently, there are many advanced intraocular lenses which can help a patient achieve spectacle independence after cataract surgery.
There are two main groups of intraocular lenses which can help reduce or eliminate the need for reading spectacles after cataract surgery:
Multifocal Intraocular Lenses: They have several focal points. Current models of multifocal intraocular lenses come as trifocal models, which have distant, intermediate and near focal points. The aim is to enable patients to be spectacle independent for most activities.
Extended Depth of Focus (EDOF): Another group of intraocular lenses is the EDOF intraocular lenses. Such lenses increase the depth of focus to allow patients to see distant and intermediate objects. The main advantage of EDOF intraocular lenses is the lower incidence of night vision symptoms, which can occur with multifocal intraocular lenses.
Extended depth of focus Implantable Collamer Lens (EDOF ICL)
Extended depth of focus or EDOF ICL lenses will soon be available as a novel treatment option for myopic patients (aged 40-50 years) who are also presbyopic and want to be spectacle-independent following ICL surgery. This presbyopia treatment can preserve both the cornea and crystalline lens.
Presbyopic Eye Drops
There are several prescription eye drops which aim aims to improve the near vision by increasing the depth of focus of the eye. Patients will need to use the eyedrops daily and have to be monitored regularly. However, these eye drops are still under study for their efficacy and safety.
PRESBYOPIA TREATMENT AT ADVANCED EYE CLINIC & SURGERY
CANDIDACY FOR ICL SURGERY
ICL surgery can be performed on any patient with sufficient space in the eye for the ICL. However, it is most beneficial for patients,
– who are between ages 21 and 45
– with a very high degree of refractive errors
– whose corneal scans are abnormal
– with thin corneas (insufficient for corneal laser refractive surgery)
– with stable vision prescriptions (have not changed for at least a year)
– with dry eyes
As with all surgical procedures, a thorough ophthalmic evaluation by a qualified ICL surgeon in Singapore is necessary to determine the suitability of candidacy.