Is presbyopic laser surgery better than lens replacement?
It depends. Patients often ask me that, and one can’t decide fully examining the patient. Because the choice of treatment depends on the patient’s spectacle prescription, the age of the patient, the health of the eye, and the scans of the cornea of the eye.
If both procedures are suitable here is why presbyopic laser surgery is the better option
Now, there may be some patients for whom either procedure is suitable. And in those patients, in my opinion, presbyopic laser surgery is the better option.
And the reason for that is it’s more accurate than refractive lens replacement, and it’s safer than refractive lens replacement. And it’s more accurate because the laser is calibrated to re-mould the cornea in little microns, a thousandth of a millimetre in shape, whereas lens surgery is in half diopters steps. So, it’s less precise. And laser eye surgery is also much more accurate if patients have pre-existing astigmatism. For although we can correct astigmatism with refractive lens surgery, laser eye surgery is better at doing that.
Also, corneal laser refractive surgery is a surface-based treatment. It’s on the surface of the eye. As opposed to lens surgery, which is an intra-ocular procedure operating on the inside of the eye. So, in patients suitable for both, generally, my preference is presbyopic laser surgery.
When it would be suggested to perform refractive lens surgery
On the other hand, in patients who have a very high long-sighted prescription, or who have the beginnings of a cataract, then refractive lens surgery would be a more obvious choice for that patient.
More about Robert Morris
Rob Morris is a Consultant Ophthalmic Surgeon at The Grange Eye Consultants. His special expertise is in cataract and refractive surgery, including Refractive Lens Exchange, and adult squint. He has over 30 years of experience in treating people with eye problems. Rob Morris founded Grange Eye Consultants to manage the increasing demand for more complex refractive surgery. He leads clinical trials investigating novel eye treatments. He is currently Medical Director at Optegra Eye Hospitals.