Surgical Correction of Presbyopia

Lenticular, Corneal, and Scleral Approaches

Michael Greenwood, MD; Shamik Bafna, MD; Vance Thompson, MD


Int Ophthalmol Clin. 2016;56(3):149-166. 

In This Article

Presbyopic Excimer Laser Ablation (PresbyLASIK)

Using LASIK as a means to provide multifocality has also been developed as a surgical treatment of presbyopia. Central and peripheral presbyLASIK, named for the areas where the ablation takes place, are 2 techniques that can be used. A third technique, transitional multifocality, has largely been abandoned. Central and peripheral presbyLASIK differ in that central presbyLASIK essentially creates a bifocal, whereas peripheral presbyLASIK increases the range of pseudoaccommodation.[38]

Central presbyLASIK involves the creation of a hyperpositive area in the central cornea allowing for near vision correction. Peripheral presbyLASIK creates a negative peripheral asphericity by ablating the peripheral cornea, which allows for an increase in depth of focus.

Studies involving central presbyLASIK show UDVA results between 20/25 and 20/20, and UNVA of J2 for most patients.[39] Peripheral presbyLASIK also showed good results with 98% and 100% of patients having UDVA 20/20 and 20/32 or better, respectively. Uncorrected near visual acuity was J2 in 96% of patients and J3 or better in 99%.[39–43] Even though optically the results are predictable and good with presbyLASIK, some patients are dissatisfied by the minor loss of distance visual acuity in the treated eye.[44]