Eyeworld

EW FEATURE 37 EyeWorld takes a look at corneal approaches to presbyopia treatment that have been successful in Europe A t present, monovision LASIK is the only FDA- and Health Canada-ap- proved corneal procedure for presbyopia treatment, according to W. Bruce Jackson, M.D., professor of ophthalmology, director of refractive surgery, Univer- sity of Ottawa Eye Institute, Ottawa. Routinely performed in presby- opia patients who have not devel- oped cataracts, monovision LASIK creates a distance focus in the domi- nant eye and a near focus in the non-dominant eye. Newer proce- dures presbyLASIK and INTRACOR (Technolas Perfect Vision, St. Louis), however, create multifocality in the cornea. PresbyLASIK is performed with an excimer laser while INTRA- COR utilizes the femtosecond laser. Multifocal LASIK In presbyLASIK, surgeons reshape February 2011 June 2011 PRESBYOPIA by Enette Ngoei EyeWorld Contributing Editor Corneal approaches to presbyopia: Creating multifocal corneas AT A GLANCE • Monovision LASIK is a better option, and ultimately a lens-based option is the best as it gets at the root of the problem—the natural lens's loss of accommodation and overall stiffening. On the other hand, a multifocal cornea with presbyLASIK can provide enhanced near vision as well as good distance vision correcting myopia, hyperopia, and astigmatism • There are also some downsides to presbyLASIK, the biggest of which, as with monovision LASIK, is the temporal nature of the treatment approach • With the INTRACOR procedure, sur- geons change the shape of the cornea, making the central part of the cornea a little steeper, essen- tially creating a magnifying glass in front of the eye. Without cutting open the corneal surface as would be done for a flap procedure, the surface remains untouched and there is no risk for infection be- cause there's no way bacteria can get into the cornea • Patients need to know that with current presbyopia treatment pro- cedures, good light conditions are important. Patients always have a near point at a specific distance from the eye, and they need to adapt to this new situation continued on page 38 the cornea into different zones for near, distance, and intermediate vi- sion, allowing patients to regain good vision at all distances. The pro- Now available EyeWorld.org/ascrsalconlivesurgery2011 Live Surgery in High Defintion from the 2011 ASCRS•ASOA Symposium and Congress Host Surgeon: Robert J. Cionni, MD Faculty: Ike K. Ahmed, MD Rosa M. Braga-Mele, MD Richard J. Mackool, MD Stephen G. Slade, MD Sponsored by © 2011 Novartis AG MCA11585JAD 5/11

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