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Presbyopia Treatment
Presbyopia treatment is a procedure for restoring near vision in presbyopic eyes.
Minamiaoyama Eye Clinic offers a range of surgical options for correcting presbyopia, including monovision LASIK, presbyopic LASIK, conductive keratoplasty (CK) and hyperopic LASIK. Those who have both presbyopic and cataract symptoms also have the option of receiving multifocal intraocular lenses (IOLs) designed to help presbyopic patients to focus on both distant and near objects.
Presbyopia
People with good vision and people who rely on the aid of glasses or contact lenses for distant vision adjust focus for close objects by altering the thickness of the crystalline lens, which functions as an intraocular lens. Age-related loss of elasticity to the crystalline lens and weakening of the muscle that adjusts the crystalline lens thickness lead to a declined ability to adjust focus and makes it more difficult to see close objects. This condition is called presbyopia. Around the age of 45, most people begin having trouble reading newspapers or the display on cell phone screens and realize they have presbyopia as such inconveniences in daily routines increase in frequency.
Types of Presbyopia Treatments
When treating presbyopia, it is important to choose the treatment option most suitable to your lifestyle.
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Monovision LASIK results in good distant vision in one eye and good near vision in the other eye after LASIK procedure that treats presbyopia and nearsightedness, farsightedness and astigmatism. |
Presbyopic LASIK is suitable for presbyopic patients who also have nearsightedness, farsightedness and astigmatism and who desire to be able to see both distant and near to some extent following a LASIK procedure. |
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CK is a procedure that corrects farsightedness or improves near vision in presbyopic patients. |
Hyperopic LASIK reshapes the cornea into a convex shape, making it easier for patients to see distant, intermediate or near, thereby alleviating eye fatigue. |
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Multifocal IOLs (for both distant and near vision) have both distant and near focal points and, when implanted after cataract removal, reduce the frequency of the postoperative need for patients to use reading glasses. |
Monovision LASIK
Monovision LASIK results in good distant vision in one eye and good near vision in the other eye after LASIK procedure that treats presbyopia and nearsightedness, farsightedness and astigmatism (for instance, a difference in visual acuity between the right and left eyes, with the right eye at 1.0(20/20) and the left eye at 0.25(20/80)). Monovision LASIK enables a patient to go through daily routines without the need for eyeglasses to see both distant and near objects.
| Advantages | Patients will be able to see both distant and near objects to some extent without the aid of glasses. |
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| Disadvantages | It will take one to three months to adapt to monovision. If you are still having difficulty adjusting to monovision after three to six months, another surgery may be performed to correct the vision in one eye to match your desired vision in the contralateral eye.
With a potential for decreased stereoscopic acuity, this procedure may not be suitable to those who operate vehicles or perform fine detailed work. |
Surgery
In the suitability exam and the final preoperative exam, a monovision situation will be created to verify your tolerance for it. The degrees of surgical correction will also be determined for the emmetropic eye for distant vision and for the slightly myopic contralateral eye for near vision. The procedure for monovision is the same as conventional LASIK.
Example) Images seen through monovision with the right eye corrected for distant vision and the left eye corrected for near vision
Presbyopic LASIK
Presbyopic LASIK correction is suitable for presbyopic patients who also have nearsightedness, farsightedness and astigmatism and who desire to be able to see both distant and near to some extent following the LASIK procedure without the aid of glasses. Presbyopic LASIK uses a laser to reshape the cornea so that the central part of the cornea is focused on the distant and the periphery is focused on the near, or the other way around, providing both distant and near vision.
| Advantages | Patients will be able to see both distant and near objects to some extent without the aid of glasses. |
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| Disadvantages | It will take one to three months to obtain stable visual acuity. The distant and near vision provided by this procedure may not work adequately in people with eyes that have a small pupil. You may need eyeglasses to read fine print. |
Surgery
The procedure for presbyopic LASIK is the same as conventional LASIK. An excimer laser is used to ablate the cornea into a contour similar to that of a bifocal contact lens with several levels of ablation diameter and correction.
Conductive Keratoplasty (CK)
CK corrects farsightedness or improves near vision in presbyopic patients. CK uses a high-frequency wave that is also used in vascular, cardiac and dental surgeries to shrink the tissue (collagen) in the periphery of the cornea, creating a sharp curvature at the central part of cornea to correct farsightedness or to improve near vision in presbyopic patients.
| Advantages | Patients will be able to see both distant and near objects to some extent without the aid of glasses. |
|---|---|
| Disadvantages | It will take one to three months to obtain stable visual acuity.
You may need eyeglasses to read fine print. |
Surgery
In CK procedures, a high-frequency wave is delivered from the tip of a fine needle (Fig.1) to the peripheral cornea 6 to 8 mm from the center (Fig.2), shrinking only the peripheral corneal collagen tissue and altering the corneal curvature (Fig.3). This altered corneal curvature changes the refraction of light entering the eye and enables the correction of farsightedness or presbyopia. The procedure takes only a few minutes per eye.
Hyperopic LASIK
Hyperopic LASIK is similar to the LASIK procedure for correcting nearsightedness. To treat nearsightedness, the cornea is ablated into a concave contour. To treat farsightedness, on the other hand, the cornea is reshaped into a convex contour to increase refractive power so as to bring the focal point closer. For those who used to be able to adjust focus on near objects, but have suffered an age-related decline in their ability to adjust focus, this LASIK treatment offers help by making it easier to focus on near objects. This procedure makes it easier for patients to see intermediate and near distances, thereby alleviating eye fatigue.
| Advantages | Patients will be able to see both distant and near objects to some extent without the aid of glasses. |
|---|---|
| Disadvantages | It will take one to three months to obtain stable visual acuity. Although this procedure improves patients’ intermediate and near vision, it reduces distant vision. You may need eyeglasses to read fine print. |
Surgery
The surgical procedures are the same as conventional LASIK, and patients must undergo a suitability exam and consultation. An excimer laser is used on the cornea to reshape it into a contour shown in the figure on the right.
Prices
The cost of presbyopia treatment is as follows (including consumption tax).
| Monovision LASIK | One eye | 170,000 JPY | |
| Both eyes | 330,000 JPY | ||
| Presbyopic LASIK | One eye | NIDEK Laser | 220,000 JPY |
| VISX Laser | 270,000 JPY | ||
| Both eyes | NIDEK Laser | 430,000 JPY | |
| VISX Laser | 530,000 JPY | ||
| Conductive Keratoplasty (CK) | One eye | 100,000 JPY | |
| Hyperopic LASIK | One eye | 170,000 JPY | |
| Both eyes | 330,000 JPY | ||
| Multifocal intraocular lenses (IOLs) | One eye | 600,000 JPY | |
