Presbyopia - Smart Lens (Close Vision Problem)

It is the impaired near vision as a result of loss of flexibility in the intraocular lens with the increasing age. It starts at the age of 40-42 and progresses continuously until the age of 60. If we compare the lens of our eyes to the lens of a camera, it is the human response of not being able to zoom in on a nearby object, so the text to be read in close distance is taken far by the person.

What is the reason?

Your eye lenses normally change shape to focus on objects. For example, if you are looking at a nearby object, the ciliary muscles contract and allow the lens to thicken, that is, to become chubby. The end result is the right focus on the subject. However, as the lenses harden in old age and the muscles lose their elasticity, it is difficult to see close objects. The resulting discomfort is called presbyopia.

What are the symptoms?

- Failure of the eye to focus on nearby objects
- Difficulty in the eyes
- Fatigue in the eyes
- Maybe headache

If you extend the text you are trying to read to the farthest level your arm can reach;

If you prefer to use big touch phones,
If you are typing and reading with large fonts on the computer,
If you cannot read the newspaper you read during the day and the book in the evening,

How is it treated?

There are many treatment methods applied on this subject in the world. These treatment methods have their own advantages and disadvantages.

Today, there are many treatment methods applied on this subject. Treatment with glasses is done with bifocal glasses and multifocal (progressive) glasses. In addition, there are multifocal contact lenses produced for this purpose.

Surgically, there are many approaches in the treatment of presbyopia. These are removing the natural lens of the person and replacing the multifocal intraocular lens, placing a second lens into the eye without removing the natural lens (icl), putting a filter system between the corneal layers (inlay methods) and performing corneal ablation with the supracor method.

These treatment methods have their own advantages and disadvantages. Currently, intraocular multifocal lens operations and supracor laser treatments are successfully applied all over the world for presbyopia treatment.

What is done in surgery?

Surgical methods are divided into two according to whether the cornea (transparent tissue in front of the eye) and the lens are interfered.

Laser treatment is applied to the cornea, the method we call monovision. The classic excimer laser procedure is applied, but one eye is adjusted to see the close distance well and the other to see far. In the method called Sopracor, the laser procedure applied to classical young patients is applied, but the applied laser is applied in a form that will be effective both near and far distance. Stages of the classic excimer laser:

-The process of removing the visual impairment with the LASIK method starts with the anesthetization of the transparent part located outside the eye and called the cornea.
- 1-2 drops of medication is enough for anesthetization.
-Thus, the patient is prevented from suffering during the treatment.
- With the help of a device, a thin layer is removed from the transparent layer.
- The laser beam that corrects the refractive impairment is applied to the layer under the lid removed.
-The layer is seated.
- The process is ended in this way.

Another method is the inlay placement between the corneal layers, with a small hole in it for close focusing.

Surgical intervention can be done on the lens. The natural lens of the eye is removed and replaced by a multi-focus (near + middle + far) lens. In addition, presbyopia can be treated by placing a second lens into the eye with the icl method where natural lens is not removed.

These treatment methods have their advantages and disadvantages. Currently, personal treatment is applied in our clinic for presbyopia treatment. After deciding on proper application, the most appropriate treatment for the person is selected with the patient for the most advantage and the least complication risk calculation and then applied.

When to return to normal life?

LASIK treatment takes 2-3 minutes for each eye. This procedure does not require hospitalization. After the procedure, the patient is checked and sent to his home with his eyes open. After the treatment, the patient may experience blurred vision, stinging, watery eyes, and mild pain for 5-6 hours, so it is recommended that patients sleep on the day and night of the operation. On the first day after the operation, the corneal layer of the patient returns to normal and the patient can return to his/her normal life. The appropriateness of the eye structure is much more important for LASIK treatment than the degree of the patient's eye. Transparent layer thickness laser is to be applied for treatment should be within the safety limits.

Is it a safe method?

  • LASIK operation is not recommended for those with congenital or genetic corneal disease (such as corneal dystrophies).
  • This treatment is not suitable for pregnant women and nursing mothers.
  • There should be no change in your diopter values in the past year.
  • You should not have an active eye infection.
  • You must not have had herpes. Laser therapy can cause herpes infection to recur.
  • Those with rheumatic diseases such as Sjogren's syndrome, rheumatoid arthritis, lupus, and those with xerophthalmia are not suitable candidates for laser treatment.
  • Those with keratoconus, cataract, glaucoma, and some retinal and optic nerve diseases are not suitable candidates for laser relief treatment.

No treatment in medicine is risk-free and uncomplicated. Excimer laser treatments, on the other hand, are among the least complicated treatments in medicine and can be applied safely except for the cases we have listed above. Supracor treatment is no different from other excimer laser procedures in terms of technique of operation, it is a method with proven safety.

Are there other methods used for presbyopia?

Supracor therapy is a good alternative to laser treatments that are applied by performing traditional monovision (focusing of one to close, one eye to far distance).

In the supracor method, which is a method that is interfered with the cornea, the tissue is treated with excimer laser after the corneal flap is removed just as in the classical lasik method. Thus, the refractivity of the eye is adjusted for both close, medium and far distance.

In the Supracor method, the eye is not pierced, so the risk of infection is extremely low compared to the operations that the lens is removed from the eye.

If the patient wants to return to the postoperative state, it is possible to realize this in the Supracor method. The patient may have a cornea as if it is not close to his/her request.

Does the problem recur despite the operation?

The corneal layer of the eye is irreversibly changed during the operation. In the postoperative period, a very small amount (approximately 0.50D) return is experienced in diopter value, but the problem does not recur due to the change in the cornea layer.