Restore near vision without glasses using laser treatment in Paris with Dr Gozlan — myopia, astigmatism and hyperopia corrected at the same time.
Presby-LASIK is now a gold-standard technique for laser presbyopia surgery. Painless and quick, it restores comfortable near vision to the vast majority of patients without sacrificing distance vision : reading glasses become a thing of the past, or very nearly so. Dr Gozlan, ophthalmic surgeon holding a University Diploma in Refractive Surgery and Phacoemulsification (University of Toulouse), explains in detail the principle, indications, procedure, recovery, results, risks and cost of this surgery.
Presby-LASIK is a variant of LASIK dedicated to the correction of presbyopia. Like standard LASIK, it combines two lasers : a femtosecond laser creates a thin corneal flap, then an excimer laser reshapes the cornea. The difference lies in the sculpted profile : instead of a simple correction, the laser shapes a multifocal cornea (zones dedicated to near and distance vision) or applies micro-monovision between the two eyes. The eye thus regains the ability to see clearly at multiple distances. The procedure takes approximately fifteen minutes for both eyes and requires no hospitalisation.
Presbyopia is not a disease but a natural change in the eye. With age, the crystalline lens loses its flexibility and the muscle that deforms it weakens : the eye can no longer accommodate, meaning it can no longer focus on close objects. Reading, phone use and screens become blurry, and text is held further away to see more clearly. It begins around the age of 45 and progresses until approximately age 60. Presby-LASIK does not rejuvenate the crystalline lens : it modifies the optics of the cornea to compensate for this loss of accommodation.
This procedure is intended for presbyopic patients who are bothered on a daily basis by their dependence on reading glasses and whose vision is stable. Presby-LASIK is particularly suitable :
When the cornea is too thin, surface Presby-PKR is often a better option. And if the crystalline lens is beginning to become cloudy, lens replacement surgery may be preferable. Only a comprehensive preoperative assessment can confirm that Presby-LASIK is the safest solution for your eyes.
One of the major advantages of Presby-LASIK is the ability to treat several refractive errors in a single session. Many presbyopic patients are not only affected at near distance : they are also myopic, hyperopic or astigmatic. The same laser treatment corrects :
The goal is clear near and distance vision without optical correction for most everyday activities.
No surgery is performed without a thorough preoperative assessment. This painless examination lasts approximately one hour and is essential to ensuring the safety and quality of the outcome. It includes :
Important : contact lenses must be removed several days (soft lenses) to several weeks (rigid lenses) before the assessment, as they temporarily alter the shape of the cornea and distort the measurements.
Presby-LASIK is performed on an outpatient basis, in six steps. You remain awake, lying comfortably ; the procedure on both eyes takes approximately fifteen minutes.
As with LASIK, recovery after Presby-LASIK is rapid. In the hours that follow, a gritty sensation, watering and light sensitivity are normal. Vision begins to clear by the same evening. One distinctive aspect of presbyopia surgery : the brain must adapt to multifocal vision or micro-monovision, which may take a few days to a few weeks.
Presby-LASIK acts on the cornea and is suitable when the natural lens is still clear. When presbyopia is very advanced, after the age of 55–60 years, or when a cataract is beginning to develop, it may be more appropriate to replace the natural lens with a suitable intraocular implant : this is lens replacement surgery, which involves a separate treatment pathway. The pre-operative assessment helps determine the most long-lasting solution based on age, refractive error and the condition of the lens.
Presby-LASIK and Presby-PKR correct presbyopia using the same optical principle but differ in technique. Thanks to its flap, Presby-LASIK offers a faster recovery and better immediate comfort. Presby-PKR, which works on the surface without a flap, is preferred for thin corneas, contact-sport athletes or certain high-risk occupations. In the long term, both approaches deliver equivalent results.
Presby-LASIK delivers excellent near-vision results : the vast majority of patients can read again without glasses for everyday activities while maintaining good distance vision. The outcome is stable but does not prevent subsequent ageing of the crystalline lens. A touch-up remains possible in rare cases to fine-tune the correction.
Presby-LASIK is a safe procedure derived from a technique proven through millions of cases, but like any surgical intervention it carries risks, most of which are minor and temporary :
Adherence to contraindications and the quality of the pre-operative assessment reduce these risks to a minimum.
The procedure is not performed in the presence of : keratoconus or an excessively thin cornea, unstable refraction, significant cataract, severe dry eye, certain corneal or autoimmune diseases. In cases of cataract or very advanced presbyopia, lens replacement surgery is often preferable ; in cases of thin corneas, Presby-PKR may be offered.
Refractive surgery for presbyopia is not covered by the national health insurance as it is considered an elective procedure. However, many private health insurance plans offer a "refractive surgery" package covering all or part of the procedure ; it is advisable to check your policy. The cost depends on the technique and the correction required ; a clear and detailed estimate is provided during the preoperative consultation, with no obligation.
No. The eye is anaesthetised with eye drops: during the procedure you feel no pain, at most slight pressure. In the following hours, a gritty sensation and watering are common but temporary.
Yes, that is its goal. By giving the cornea a multifocal profile or by applying slight micro-monovision, presby-LASIK restores functional near vision while preserving distance vision. Most patients no longer need reading glasses in daily life.
It is a strategy in which the dominant eye is set for distance vision and the non-dominant eye receives a slight correction for near vision. The brain combines the two images. A tolerance test is carried out during the assessment, sometimes with contact lenses, before adopting this approach.
Presbyopia results from ageing of the crystalline lens, which continues over time. The corneal correction provides lasting compensation for near-vision difficulty; if, over the years, the lens becomes cloudy (cataract), crystalline lens surgery can take over.
Yes. Presby-LASIK corrects presbyopia and, in the same session, any associated myopia, astigmatism or hyperopia. This is one of its key advantages.
Often yes. The brain needs to learn to use multifocal vision or micro-monovision: a few days to a few weeks may be required, with distance vision that may seem slightly less "sharp" at first.
The majority of patients do not experience lasting discomfort. Halos or slight night-time blur may occur in the first few weeks, inherent to multifocality, and then fade. The preoperative assessment (pupil diameter) helps limit this risk.
Presby-LASIK is intended for presbyopic patients, most commonly from 45–50 years of age, whose refraction is stable. When the crystalline lens is already significantly aged, lens replacement surgery may be preferable.
Dr Gozlan, holder of the University Diploma in Refractive Surgery and Phacoemulsification, assesses your eligibility for presby-LASIK during a comprehensive evaluation and determines with you the technique best suited to your eyes.
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