As you get older (somewhere between the ages of 40-50), changes occur in the internal focusing muscles, and the natural lens inside your eye, resulting in difficulty in focusing and seeing up close. This condition is called Presbyopia (“middle-age long-sightedness”).
This is an effective treatment option for those with refractive errors (myopia, hyperopia, astigmatism) and presbyopia. The LASIK procedure is used to correct vision such that one eye is adjusted to be better for reading vision and the other eye better for distance vision. When using both eyes together, the brain automatically adjusts without any conscious effort so that you will be able to focus at both distance and near without glasses.
Like laser vision correction, using the ICL to correct your
vision while compensating for presbyopia through monovision,
is a viable option for treating presbyopia. MonoVision
technique is also used and the aim is that you will have both
near and distance focus without needing glasses.
The advantage of using the ICL over laser
correction when you are older and presbyopic is that it is
reversible/removable, your cornea remains unchanged, and you
will be suitable for the premium
multifocal intraocular lens implant (IOL)
when you have cataract surgery in the future. The multifocal
IOL used after cataract surgery will permanently correct your
distance vision as well as give you good reading vision for
the rest of your life, assuming your eye remains healthy and
free from other conditions that can affect vision.
This will definitively treat and correct your presbyopia and give you good distance, intermediate and near focus without the need for glasses. The IOL power can be adjusted to reduce or eliminate any pre-existing spectacle prescription (myopia, hyperopia, astigmatism) as well as give you the ability to focus for near reading. There is no more need for monovision, each eye will be able to focus like the natural eye for all distances providing convenience and freedom from spectacles.
Refractive lens exchange (RLE) or Clear Lens Exchange (CLE) is the removal of a non-cataractous natural lens of the eye and its replacement with an intraocular lens (IOL) that eliminates your refractive error (spectacle prescription) and corrects your presbyopia. It is similar to and performed like cataract surgery, only that there is not yet a cataract (cloudy lens) in your eye. Hence the phrase ‘Clear’ Lens Exchange.
RLE is a viable and accepted procedure in selected patients for both myopia and hyperopia, with toric IOLs for correction of astigmatism and a multifocal IOL for the treatment of presbyopia.
*MonoVision treatment is an option which involves vision correction for different focusing distances in each eye, so that one eye is selected for reading (near) vision and the other eye adjusted for distance vision. This technique is generally employed for people who do not want to use reading glasses. (See also MonoVision with Monofocal IOLs in cataract surgery) With monovision, you do not need to make any conscious adjustments in how to see, the brain automatically adjusts so that distance and reading vision become effortless. The result is you will be able to focus at both distance and near without glasses.