Eyeworld

EW FEATURE 54 Presbyopia treatment • August 2016 by Maxine Lipner EyeWorld Senior Contributing Writer intraocular lenses at the time of either cataract surgery or refractive lens exchange. "The ideal candidate for that type of procedure is some- one who is presbyopic and who has some kind of refractive error," Dr. Gupta said, adding that this gives patients who have already lost ac- commodation and don't have clear distance acuity a better range of vision. However, there are drawbacks here also, with some patients not seeing well with such lenses due to Physicians discuss what's on the horizon as new options for presbyopia solutions are emerging M odern presbyopia tech- nology is constantly evolving, with good reason, according to Sumit (Sam) Garg, MD, medical director, Gavin Herbert Eye Institute, University of Califor- nia, Irvine, California. "Presbyopia is one of the most common refractive disorders we are presented with on Future of technology for presbyopia treatment Monthly Pulse Presbyopia treatment halos or contrast vision alterations, as well as the fact that it involves intraoperative surgery, Dr. Gupta noted. She pointed out that "for many aging patients, years prior to devel- oping a significant cataract, vision quality isn't as good as it could be, and there are some patients who really notice this." This phenome- non has been termed dysfunctional lens syndrome. AT A GLANCE • Corneal inlays, including the newly approved Raindrop Near Vision Inlay, are among the new technologies practitioners are relying on to tackle presbyopia. • The extended depth of focus lens option elongates the visual focal point and can provide presbyopes with a greater range of vision. • New non-surgical treatment options for presbyopia are on the horizon; these eye drops can stimulate miosis without accommodation and are under investigation as a way to offer presbyopes near vision without compromising distance. The Kamra Inlay offers near vision while maintaining distance acuity by using a small aperture to extend the depth of focus. Source: William Wiley, MD a daily basis," Dr. Garg said, adding that there are an estimated 2 billion presbyopes worldwide. Mounting demand for technology While spectacles or monovision traditionally have been the go-to technologies, new options are begin- ning to emerge, with many clamor- ing for better technology. Dr. Garg views this new demand for better presbyopia options as the result of the popularity of refractive surgery in the 1990s and early 2000s, with many of these patients who have now become presbyopic looking for near vision solutions with fewer drawbacks. The fact is, Dr. Garg said, while monovision works, it also has its downsides. These include de- creased binocularity, fixed focus at either near or intermediate for the non-dominant eye, decreased at all distance, and an intolerance of the technology for some. Preeya Gupta, MD, assistant professor of ophthalmology, cornea and refractive surgery, Duke Uni- versity Eye Center, Durham, North Carolina, agreed that newly presby- opic patients, many of whom have already experienced the benefits of laser vision correction, are now seeking something that is safe and effective to fix their presbyopia with- out compromising binocular vision. Another mainstay of presbyopia treatment is the use of multifocal Yes No Multifocal IOL (including EDOF) Accommodating IOL Corneal inlays Monovision Do you offer surgical options for the correction of presbyopia? What is your current preferred approach for the treatment of presbyopia? EyeWorld Monthly Pulse is a reader survey on trends and patterns for the practicing ophthalmologist. Each month we send an online survey covering different topics so readers can see how they compare to our survey. If you would like to join the physicians who take a minute a month to share their views, please send us an email and we will add your name. Email carly@eyeworld.org and put "EW Pulse" in the subject line.

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