Presbyopia is the reduction of the power of lens accommodation occurring gradually and manifesting itself from 40 years old. Presbyopia prevents you from seeing close objects.
A preoperative assessment is essential in refractive surgery. It allows your surgeon to choose the most appropriate surgical technique for you (which may be PRK, LASIK, PRESBYLASIK or implants) and to check the absence of contraindications.
Indeed, even if refractive surgery corrects visual defects (myopia, hyperopia, astigmatism and presbyopia), compliance with the contraindications avoids post-operative complications. The quality of the preoperative indication determines the quality of the result. This consultation also helps to answer the patient’s questions.
At Clinique de la Vision, for example, a preoperative consultation includes:
- Measurement of ametropia (visual defect) to be corrected by refraction analysis
- The verification of the “dominant” eye (or “director”) essential when correcting symptoms of presbyopia
- The complete ophthalmic assessment with measurement of the intraocular pressure, examination of the fundus and especially the analysis of the transparency of the lens
- The analysis of corneal morphology (curvature, shape, thickness) thanks to corneal topography eliminates the contraindications to laser surgery and to choose the most appropriate surgical technique for the patient
- Aberrometric examination analysis of the optical quality of the eye
- Calculation of the implant is performed if lens surgery is considered
- Finally, other explorations can be done depending on the context.
It is only at the end of this assessment that a surgeon can make a recommendation. They can then choose the most suitable refractive surgery technique for you.
Finally, the surgeon must clearly explain the advantages, the possible undesirable effects and the expected results of their recommended procedure.
Surgeons can correct presbyopia with several laser techniques PRK, LASIK, SMILE or ICL in case of strong presbyopia. Patients can also benefit from a lens surgery with implant placement in case of cataracts.
When we consider surgery for presbyopia, it is crucial to determine ocular dominance plan the treatment. We then correct the dominant eye for distance vision, and the correct the non-dominant eye for near vision.