PRESBYOND® LASIK
Dr Au offers PRESBYOND at Eye Laser Specialists clinic only
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What is Presbyopia?
Presbyopia is the gradual loss of the eyes' ability to focus on nearby objects. It gradual becomes more noticeable from early to mid 40s and worsens until the age of 65. It is most commonly managed by reading glasses or under-correcting myopia prescription.
Unfortunately traditional methods only allow for sharp focus at one fixed distance and often multiple pairs of reading glasses with varying strengths may be required. More expensive bifocal/trifocal glasses may help improve convenience but not every is versed in their usage.
Monovision (with glasses, contact lenses, laser or cataract surgery) is also sometimes utilized which leaves one eye slightly short-sighted to allow for close work, while the other eye is adjusted for distance vision. Monovision works well for some patients but some are unable to tolerate it, stereoacuity (3D vision) is also compromised.
What is PRESBYOND?
PRESBYOND is a uniquely developed outpatient laser surgical procedure used to treat Presbyopia. It provides a continuous range of focus for distance, intermediate and near vision. Whilst one eye is made to be better for distance and the other for near, both eyes are still working together at all times thus no loss of stereoacuity 3D vision). PRESBYOND is only available through a ZEISS laser system.
How is PRESBYOND performed?
PRESBYOND is performed similar to LASIK as an outpatient procedure. Here is what happens:
You will be awake during the surgery and no sedation is necessary.
The surgery is generally a comfortable experience with minimal pain.
The eye is numbed with anaesthetic eye drops.
A first laser called the femtosecond laser is used to create a thin piece of tissue (the flap) on the cornea.
The flap is gently lifted.
A second laser, the excimer laser is then used to reshape your cornea.
The flap is replaced and smoothed out. No sutures (stitches) are necessary. The flap adheres (sticks) on its own.
It takes generally 10-15 minutes to perform LASIK in both eyes.
In some cases, a contact lens that acts like a bandage is placed over the cornea to allow proper healing of the flap to occur. This will be removed usually the next day.
Am I a Good Candidate for PRESBYOND Surgery?
Not everyone can have PRESBYOND or will benefit from it. Dr Au and his team will advise you accordingly.
Generally, in order to undergo PRESBYOND surgery in Australia, you should:
Be troubled by Presbyopia (typically after the age of 40)
Not be pregnant
Be free of other eye diseases
Have a stable refraction i.e. the prescription for your glasses should not have changed much in the last one year
Fulfil certain criteria with regards to cornea thickness, cornea shape and refractive error (degree). Patients with thin or irregular corneas, severe dry eye, cataract, glaucoma, uncontrolled diabetes, rheumatoid arthritis and other collagen vascular diseases are unsuitable for SMILE.
Most importantly, you must have realistic expectations about the outcome of the procedure, and be willing to accept the potential risks associated with it. Fortunately, PREBYOND is very safe, and the results excellent, and most patients are extremely happy with how the procedure has changed their lives.
What to Expect after PRESBYOND
Here are important points to note:
Visual recovery after PRESBYOND is quick but not instantaneous.
You will find that your eye sight is still foggy immediately after Presbyond. Vision usually improves gradually over the next 6 to 8 hours. By the next day, you will be able to see well enough to perform most of your daily activities and continues to improve over the week.
When the effect of the anaesthetic eyedrops wears off, some patients may experience pain, tearing, burning sensation, scratchiness and/or difficulty opening their eyes, the severity of which varies from patient to patient. These symptoms usually disappear after 6-8 hours. Most patients find the discomfort mild and bearable.
Healing after PRESBYOND is usually more comfortable than with other methods of surgery as the laser removes tissue from the inside of the cornea rather than from the more sensitive surface of the cornea.
You will be prescribed antibiotic and steroid eye drops as well as artificial tears to keep the eyes moist.
The presbyopic benefits may require some time to adapt to (76% within 3 months, 94% by 1 year but can take as long as 18months). Temporary glasses are occasionally utilized to aid adaption.
Most patients are able to return to work a day or two later. Stabilization of vision takes a few weeks, and varies from patient to patient.
What Side Effects, Risks and Complications Should I be Aware of?
Like any other surgery, PRESBYOND has side effects that you need to know about and carefully consider before deciding on having the surgery. Fortunately, PRESBYOND is a very safe procedure and most of the side effects are mild and temporary. These include dry eye, fluctuating vision, hazy vision, haloes and glare in a dim environment and light sensitivity. Over- and under-correction may also occur, and a “top up laser” procedure called “enhancement” may be required in some cases. Serious side effects that can result in loss of vision are extremely rare, and these include severe inflammation, infection and corneal ectasia (weakening and thinning of the cornea).