Refractive Surgery Options for People Over Forty

For people over the age of forty, reading becomes increasingly difficult. This inability to focus up close is called Presbyopia. It is a normal part of aging, and can not be prevented. As LASIK and PRK have increased in popularity, researchers have looked for ways to eliminate the need for reading glasses for those over 40.

Until recently, the options have been limited to mono vision LASIK, which is still the most selected option among refractive surgery patients. It involves surgically correcting one eye for the distance, and the other for near. While it is a viable option, there are still those who can not adjust to the difference in visual acuities between the two eyes. In those cases the near eye must be re-corrected for the distance, and reading glasses are required.

Another option has been a multi focal intraocular implant. It is basically a cataract operation, with an implant that has concentric rings of refractive power. One power is for the distance and the other for near. Again, there are those that are happy with the total vision, but many still complain of a lack of complete visual acuities at the distances they require. Also, glare and poor night vision are common complaints.

A relatively new procedure to attempt to address these issues, is called CK or Conductive Keratoplasty. It involves using radio waves to steepen the cornea of an individual who sees well in the distance, but wants to have better near vision. It creates a nearsighted shift in one eye and is essentially the same as mono vision with LASIK or PRK. The results will vary as well. Thus, with out a complete and very successful procedure for all patients the search continues.

The newest procedure, which is still in clinical trials, is called a Corneal Inlay. It involves lifting a flap in the cornea similar to LASIK, and placing a bio compatible disk in the middle of the tissue. It is done in one eye only and is similar to a disk with many pin holes in it. The pin holes increase the depth of field in that eye, and increases one’s ability to see at near. The test results are still incomplete, although initial data seems to indicate that there is less visual discomfort. One problem exists if the patient has a light colored iris, it will appear dark after the implant is inserted. The disk is removable simply leaving a surgical scar behind. The current clinical trials are using an Acufocus ACI 7000 implant. Only time will tell if this procedure will let all of us ‘old folks’ get rid of our reading glasses.