Presbyopia treatment: Is PRESBYOND better than lens replacement?
Is PRESBYOND better than lens replacement? The answer is, it depends. They are both effective and safe.
If you have a patient whose crystalline lens is showing signs of cataract change, the majority of those patients should be steered to having lens replacement, because in the majority of those patients the cataract change will start to compromise the quality of vision. I’d much rather do this than doing a corneal laser eye surgery procedure that may last them potentially a few months, maybe a year, before the cataract moves on. It is just not the right way to look after them I think.
What I’m always trying to do for patients is to do as little surgery as possible to them, but as much as they need. So if I see a patient who’s showing signs of early cataract, I know that that cataract will progress and it’s a one-way ticket. The lens replacement procedure offers a way of not only treating their presbyopia, providing them with excellent distance through to near vision without spectacles, but also eliminates the cataract and eliminates any possibility of developing a cataract in the future. Really what we’ve done is we’ve brought that cataract surgery forward in time, and we use the very best technology to provide them with the maximum range of focus and improve quality vision and improve the quality of life now, which they then can enjoy for the coming decades.
But conversely, if I have a patient who is maybe younger, smaller prescription or who has a crystal clear lens inside their eye, that patient may not develop significant cataracts until they’re 90. In which case, corneal laser eye surgery with blended vision LASIK is a beautiful option. Not only will it work incredibly well to provide them with a seamless range of focus now with really great quality of vision, but also future-proofs them, such that should they go on to develop cataracts in the future, a very simple elegant cataract surgery with a simple mono-focal lens will just reanimate the PRESBYOND blended vision. It’ll keep working, and it’ll just freshen up and bring it back. If the lens technology moves on and we have accommodating lenses those patients can benefit from those.
That’s why the initial assessment is so important and why we put together the suite of diagnostic equipment we have in the Custom Vision Clinic, so that we can correctly identify which patients are going to benefit from which technology and which is going to give them the very best improvement in range of focus and quality of vision.