Laser Blended Vision for Ageing Eyes (presbyopia)

Invented at London Vision Clinic, PRESBYOND® Laser Blended Vision is an innovative treatment for ageing eyes.

Causing the need to use the dreaded reading glasses, presbyopia comes to most of us – regardless of our eyesight in our youth. Coming on slowly, it often moves from being a slight inconvenience to become a real hassle in day to day living as we struggle with small text, smartphones, and restaurant menus. Most of us can accommodate or compensate for the early symptoms, and after a while, we get used to carrying reading glasses or fork out for expensive varifocals.

What is presbyopia?

Presbyopia literally translates as ‘old eye’. Unfortunately, ageing affects the eye just as it affects every other part of the body. Starting in early middle age, the lens inside the eye begins to lose its ability to change shape ‘zoom’ from distance to near and back.

As we can’t avoid ageing, nobody is immune to developing presbyopia, and if left unchecked, inevitably leads to the need for reading glasses, bifocals, or varifocals. In this short video, expert laser eye surgeon Mr Glenn Carp explains what exactly is presbyopia and how it changes the eyes as we get older.

Youtube video link

How does Laser Blended Vision work?

PRESBYOND® Laser Blended Vision — a treatment pioneered by Professor Dan Reinstein Reinstein and implemented by Carl Zeiss into their laser — can significantly reduce, or even eliminate, the need for reading glasses, bifocals, or varifocals for many years, being able to be adjusted non-invasively if things change over time.

Thousands of patients have already benefited from this remarkable treatment, which London Vision Clinic has offered since 2004.

You may have heard that LASIK Laser Eye Surgery can’t correct for reading vision, near vision, or the effects of ageing on the eye. A widespread myth is that presbyopia is only correctable by a more invasive procedure of surgically implanting a lens inside the eye.

However, this information is significantly out of date. Over 15 years ago, London Vision Clinic’s medical director, Professor Reinstein, pioneered increasing the eye’s depth of field using a revolutionary Laser Eye Surgery technique. Carl Zeiss implemented this technique in 2009 to distribute worldwide for advanced laser eye surgeons to offer to their patients.

PRESBYOND® Laser Blended Vision has major advantages over intraocular lens implants (IOLs) for patients who do not require cataract surgery. Firstly, it’s a significantly less invasive (and therefore safer) procedure. Secondly, PRESBYOND® doesn’t require the same compromises as IOLs – where multifocal IOLs can affect the quality of your vision. Thirdly, it’s more accurate than an intraocular lens and can be adjusted as the eye ages further. Only 30% of Britons require cataract surgery during their lifetimes. If this does develop, the PRESBYOND® treatment present provides even better-reading potential after cataract surgery, even if performed with standard IOLs in the NHS.

What’s more, it’s suitable for around 97% of patients with ageing eyes. In comparison, only around 60% of people can tolerate classical monovision (an alternative solution for presbyopia, which uses contact lenses or other laser systems).

PRESBYOND® Laser Blended Vision has been adopted by Carl Zeiss Meditec and programmed into their lasers, so clinics worldwide can now offer this option. While many Laser Eye Surgery clinics in the UK still resort to lens replacement surgery for correcting ageing eyes, London Vision Clinic is proud to offer PRESBYOND® Laser Blended Vision — a far less invasive option, suitable for the vast majority of patients.

Professor Reinstein explains…

Presbyopia is a word that comes from the Greek for ‘old eye’. It is when the zoom lens which is inside the eye becomes unable to change the focus of the eye from distance to near.

Every single human being eventually gets presbyopia. Most people start to notice in their 40’s.

The typical things that normal sighted people notice first is that even though the distance vision remains clear as it has been all their lives, now they are having to start to hold things further away to be able to see them up close.

Eventually the arm is just not long enough and they have to buy a pair of ‘readers’ from the pharmacy or the supermarket to be able to see up close.
If people are short-sighted to start with, they find that with their distance correction they cant zoom up close any more so need to take their glasses off to read – because they are short sighted and therefore focused at close and not dependent on the zoom lens to do the focusing for near.

If people are long-sighted to start with, both distance and near are ok when younger, but the near vision starts to get blurry at an earlier age – even in the 30’s. This is because the zoom lens is being used just to see at distance and there isn’t enough power to get things to go in focus up close. So the near vision goes first and then eventually the distance also starts to get blurry so they need glasses for both distance and near.

The simplest option is to get ready-readers from the supermarket, but the healthiest option is to see an optician or optometrist to get the eyes checked thoroughly for glaucoma and other problems such as macular degeneration and at the same time get advice on reading glasses. For most people who see well all their lives this will be the first time they ever see an eyecare professional for an eye examination. The more traditional way of surgically correcting presbyopia (ageing eyes) is to remove the natural lens and get a permanent lens replacement with a bifocal or trifocal multifocal artificial plastic lens implanted inside the eye.

However, the most modern way of correcting presbyopia now is by a modified laser eye surgery technique called PRESBYOND Laser Blended Vision which is an improvement on the the original standard LASIK laser eye surgery that is used for distance correction in younger people. PRESBYOND is different from standard LASIK and is a significant advance on lens replacement surgery because it is much less invasive and therefore safer, it is more accurate at achieving 20/20 at distance and near, it has less side effects and provides better night vision and it is adjustable and reversible as the eye ages, and PRESBYOND is even less expensive than lens replacement surgery.

Over 95% of people are suitable candidates for PRESBYOND LASIK and the procedure takes 10 minutes in both eyes, heals in a few hours and people are reading small print already the next morning. PERSBYOND is the ‘Star-Trek’ method of presbyopia correction, available already in the 21st century.

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The key advantages of PRESBYOND® Laser Blended Vision

PRESBYOND® Laser Blended Vision adjusts each eye in slightly different ways: one eye is adjusted to see mostly at a distance, and a little close-up, while the other is the opposite: mostly up close and a little at a distance.

The brain compensates for this change almost instantly, combining the two images to give much greater depth of vision, and an all-round improvement in visual acuity that means most patients can throw away those infuriating reading glasses.

  • Over 98% of PRESBYOND® Laser Blended Vision patients can read normal newsprint (‘N8’).
  • Over 90% of PRESBYOND® Laser Blended Vision patients can read the small print on medicine bottle inserts.

PRESBYOND® Laser Blended Vision vs Monovision and IOLs

As well as being significantly less invasive and safer than treatments that use IOLs, PRESBYOND® Laser Blended Vision is much more effective and easier to adapt to than monovision. Monovision uses contact lenses (or older laser systems) to make one eye focused on near and one eye focused on distance. Monovision is far less effective and is not suitable for all patients.

As mentioned, not only does PRESBYOND® Laser Blended Vision minimise the risks and compromises necessitated by IOLs and monovision, but studies have also shown that it’s suitable for pretty much anyone. So, while we may not be able to stop the ageing process in its tracks completely (at least not yet), we can make it much more comfortable and convenient for almost everyone. If you are one of the few per cent who can’t achieve full correction through laser eye surgery, Bioptics might be an option for you. This combines the lens’s power inside the eye with any residual refractive error corrected with laser eye surgery.

On a patient with presbyopia, do you prefer to perform PRESBYOND® Laser Blended Vision or a Clear Lens Exchange with a multifocal implant?
Professor Reinstein says...

Professor Reinstein says… In our clinic, when the patient has a clear lens, we would always choose to perform PRESBYOND® Laser Blended Vision over Clear Lens Exchange. Although there are arguments to support removing the natural lens inside the eye as a preventative method for cataract formation, these are still outweighed by the safer, less invasive, and more accurate PRESBYOND® Laser Blended Vision procedure. There are also fewer side effects reported following PRESBYOND® Laser Blended Vision than multifocal IOLs.

What are the advantages of PRESBYOND® Laser Blended Vision over traditional monovision?
Professor Reinstein says...

PRESBYOND® Laser Blended Vision holds a number of advantages. With an increased depth of field, patients will benefit from improved distance and immediate vision, and as a result of the ‘blend’ zone, patients are also more likely to tolerate this technique over monovision.