Presbyopia laser surgery: what do reviews and studies say?

"Presbyopia surgery reviews", "Presby-LASIK reviews": before considering surgery, it is natural to look for other people's experiences. An online review tells one individual story; published studies, on the other hand, survey groups of patients using questionnaires and examinations. Here is what they show, their limits, the most frequently reported issues and useful questions to ask at the consultation. In every case, it is the pre-operative assessment that allows the surgeon to evaluate your situation.

What an online review can tell you, and what it leaves out

A review reflects one person's experience at a given moment. It rarely states their eyesight before surgery, the technique used, their age or what was explained to them at the assessment. Yet these factors matter a great deal in presbyopia surgery, whose outcome varies from one person to another.

Reviews also often focus on something other than the medical outcome. In an analysis of 477 one-star reviews of ophthalmologists on an American website, about three complaints out of four concerned non-medical aspects: waiting time, reception, relationship with the team [7]. These aspects matter, but they say nothing about how your eyes would respond to a technique.

The US Food and Drug Administration (FDA) advises weighing the benefits and risks of refractive surgery according to your own priorities, and trying not to be influenced by friends who have had the procedure [1].

A few pointers for reading a review

• timing: a review written a few days after surgery describes the recovery period, not the stabilised result (see Recovery after Presby-LASIK);
• technique and reason for surgery: LASIK for myopia in a 30-year-old says nothing about presbyopia surgery after 45;
• initial expectations: satisfaction also depends on what the person hoped for, and their visual needs are not necessarily yours;
• the issues described (dryness, halos, reading in low light): they are worth knowing about so you can discuss them with the surgeon.

What satisfaction studies measure

Studies survey patients with questionnaires before and after surgery. Most concern LASIK for myopia, hyperopia or astigmatism in younger adults, not presbyopia surgery.

A literature review published in Ophthalmology gathered 19 studies covering 2,198 patients who had LASIK between 1995 and 2003: the reported satisfaction rate was high [2]. These data concern different techniques and patients; they cannot simply be applied to presbyopia.

The PROWL studies, conducted with the FDA in 574 people aged 21 to 57 using validated questionnaires, give a more nuanced picture. Most participants were satisfied, but 43 to 46% reported a new visual symptom at 3 months (halos, glare, double images or starbursts around lights). Among those without dry eye symptoms before surgery, about 28% reported them at 3 months [3]. The authors stress the need to inform patients about these possible symptoms before surgery [3].

And for presbyopia surgery?

Data specific to presbyopia are more limited. A systematic review published in 2023 included 23 studies of recent Presby-LASIK techniques: 21 case series and 2 non-randomised trials, which corresponds to a limited level of evidence [4]. A 2017 review describes the different Presby-LASIK approaches and compares their distance and near vision outcomes [9].

A review published in 2025 points out that no technique, surgical or otherwise, has yet restored the eye's natural accommodation, and that patient selection and a precise pre-operative assessment are prerequisites [5]. The principles of Presby-LASIK and Presby-PRK are explained on the Techniques page.

The most frequently reported issues

Negative reviews and studies often describe the same points. In a series of 101 dissatisfied patients seen after refractive surgery performed elsewhere, the most common complaints were blurred distance vision, halos and night-vision problems, and dry eye [8].

• Dry eye: laser surgery of the cornea is one of the recognised causes of dry eye, notably because it cuts small corneal nerves [6]. It may decrease over the months but persist in some patients [1, 3]. The eye surface and tears are therefore examined at the pre-operative assessment.
• Halos and glare at night: they are among the visual symptoms described after LASIK [1, 3]; this is covered in detail in the article Night driving after Presby-LASIK.
• Glasses still useful: someone who used reading glasses before surgery may still need them afterwards [1], for example for small print or in low light. See Presby-LASIK or reading glasses: what are the differences?
• Adaptation: with monovision, the brain has to get used to one eye set for distance and the other for near, at a pace that varies from person to person (see Monovision and presbyopia).
• Change with age: eyesight keeps changing after surgery, as explained in the article Can presbyopia come back after laser surgery?

These issues are not systematic and their intensity varies from person to person. Knowing about them in advance makes it possible to discuss them with the surgeon and to have realistic expectations: the aim is to reduce dependence on glasses, with no guaranteed result.

The role of the pre-operative assessment

Several studies stress that satisfaction depends on patient selection and on the information given before surgery [3, 5, 8]. The pre-operative assessment includes in particular:

• refraction, for distance and near, checked if needed after dilating the pupil;
• corneal topography and tomography, as well as pachymetry (corneal thickness);
• examination of the eye surface and tears;
• identification of the dominant eye and assessment of near vision;
• a discussion of your visual needs: reading, screens, night driving, activities.

The criteria examined are detailed in the article Am I a candidate for presbyopia laser surgery? Pre-operative examinations take place at 4, rue Donizetti, 75016 Paris, Monday to Thursday from 9 am to 6 pm, at a time that suits you. Based on the results, the surgeon tells you whether laser surgery is possible, which technique he proposes and what can realistically be expected for your eyes. The procedure is described on the Day of surgery page and the fees on the Fees page.

Questions to ask at the consultation

Rather than comparing reviews, it helps to prepare your own questions:

• Do my cornea and eye surface allow laser surgery?
• Which technique do you propose, and why in my case?
• What distance, intermediate and near vision can be aimed for, and for which activities might glasses remain useful?
• Which issues are possible (dryness, halos, adaptation) and how are they managed?
• Would a monovision trial with contact lenses be useful before deciding?
• How is follow-up organised after surgery, and is an enhancement sometimes considered?
• What happens if a cataract develops later?

FAQ: reviews of presbyopia surgery

Sources

1. U.S. Food and Drug Administration (FDA). LASIK: What are the risks and how can I find the right doctor for me? fda.gov. fda.gov
2. Solomon KD, Fernández de Castro LE, Sandoval HP, et al. LASIK world literature review: quality of life and patient satisfaction. Ophthalmology. 2009;116(4):691-701. PubMed 19344821
3. Eydelman M, Hilmantel G, Tarver ME, et al. Symptoms and satisfaction of patients in the Patient-Reported Outcomes With Laser In Situ Keratomileusis (PROWL) studies. JAMA Ophthalmology. 2017;135(1):13-22. PubMed 27893066
4. Fernández J, Molina-Martín A, Rocha-de-Lossada C, et al. Clinical outcomes of presbyopia correction with the latest techniques of presbyLASIK: a systematic review. Eye. 2023;37(4):587-596. PubMed 35864161
5. Kohnen T, Biller ML, Lwowski C, et al. Treatments for presbyopia. Deutsches Ärzteblatt International. 2025;122(18):501-507. PubMed 40554654
6. Gomes JAP, Azar DT, Baudouin C, et al. TFOS DEWS II iatrogenic report. The Ocular Surface. 2017;15(3):511-538. PubMed 28736341
7. Smith JF, Shah AA, Qureshi MB, et al. Characterizing extremely negative reviews of ophthalmologists on Yelp.com. Seminars in Ophthalmology. 2022;37(5):661-667. PubMed 35403560
8. Jabbur NS, Sakatani K, O'Brien TP. Survey of complications and recommendations for management in dissatisfied patients seeking a consultation after refractive surgery. Journal of Cataract and Refractive Surgery. 2004;30(9):1867-1874. PubMed 15342048
9. Vargas-Fragoso V, Alió JL. Corneal compensation of presbyopia: PresbyLASIK: an updated review. Eye and Vision. 2017;4:11. PubMed 28413804

Going further

• Techniques: Presby-LASIK and Presby-PRK, principle and procedure;
• Pre-operative assessment: what is measured before any proposal;
• Day of surgery: how the procedure takes place;
• Am I a candidate?: the criteria examined before presbyopia surgery;
• Night driving after Presby-LASIK: halos, contrast and adaptation;
• Fees: fees and reimbursement.