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QUESTION:
Hello, I had lasik about 7 years ago. My vision has been perfect but the last few months, I’ve been needing reading glasses (they told me eventually I would). I was wondering if another procedure might correct this…I will be in New Jersey [soon]. I don’t want to do anything risky, but if I can get rid of those pesky reading glasses I would have more room in my shirt pocket!! Thanks! Bill
ANSWER:
Hi Bill. Thanks so much for your question.
LASIK provides excellent distance vision without glasses. In patients younger than their mid 40’s, close vision is not compromised, as they still have the ability to focus up close. Once one gets past their mid 40’s, the natural lens in our eyes looses its ability to change shape. This is called presbyopia. As young LASIK patients approach the presbyopic years, they will begin to lose their ability to see up close, and find themselves reaching for over the counter reading glasses.
Many of these LASIK patients ask what can be done to eliminate the readers. This can be treated non-surgically with either bifocal contact lenses, or monovision contact lenses (1 eye near and 1 eye far.)
Surgically, presbyopia may be treated by the following approaches:
1. Near vision CK can temporarily improve the near vision in 1 eye, but will only last for a few years.
2. Treating 1 eye for near with a LASIK enhancement to create a monovision correction. This is also a compromise, and will become less effective with time.
3. Refractive lens exchange with the implantation of a multifocal IOL gets to the root of the problem: the inability of the natural lens to focus. By replacing it with an artificial IOL, patiets are now able to see both near and far. This is a permanent correction that will not fade with the aging of the eye. This is my preferred treatment of choice for the correction of presbyopia. In both previous LASIK patients and those who have never had surgery.
Best,
Cary M. Silverman, MD
