Femtosecond Lasers Used in Experimental Presbyopia Surgery

MEXICO CITY, MEX.–Presbyopia is a vision condition facing most men and women as we age. Beginning in 40s, our eye begins to lose its ability to accommodate, or change its focus to look at objects at different distances. Now an ophthalmologist in Mexico City is developing a new technique for treating this condition using the latest-generation femtosecond lasers.

Femtosecond lasers have been used for years to perform what is known as bladeless LASIK. In bladeless LASIK, the femtosecond laser is used instead of the mechanical microkeratome to create the corneal flap. Femtosecond lasers have the ability to penetrate deep into the cornea without disturbing the surface layer. The experimental procedure takes advantage of this ability to reshape the internal topography of the cornea, steepening it to provide the cornea with vision zones like those in the multifocal intraocular lens ReZoom.

Results, reported in Optical Surgery News,  are very preliminary for this new technique, but they seem promising. In a short series of 19 patients who had one eye treated, the technique improved near visual acuity from 20/80 to 20/30 after a 3-month follow-up. This procedure is not to be confused with LASIK monovision, which is an FDA-approved procedure that corrects one eye for near vision and leaves the other unchanged for distance vision. In general, monovision gives good results, although some patients have a significant adjustment period.

The exact cause of presbyopia is not known, although some believe it is related to changes in the structure of the crystalline lens that will ultimately result in cataracts. The traditional solutions for presbyopia treatment were reading glasses or bifocals.  More recently, clear lens exchange has been advocated as a solution. In this procedure, essentially a preemptive cataract surgery, the normal lens is replaced with a premium intraocular lens that restores a range of vision, potentially even giving full vision back. One problem with clear lens exchange is that patients may see an increased incidence of glare, halos, and starburst, also a risk for LASIK monovision. The patients treated with the new femtosecond laser technique did not report glares, halo, or starburst after three-month follow up.

Although it is likely to be many years before this procedure is available for patients in the United States, there are many presbyopia treatment options available. To learn which one might be right for you, please contact a local ophthalmologist and schedule a consultation today.