Who should choose which one? The need for good visual acuity without correction is increasing these days, including among people over the age of 45. The question that ophthalmologists are increasingly asking is how we can become partially or completely free of glasses, and what are the possible surgical solutions.
However, this age group has to face the change that we call presbyopia, an old Hungarian term for old age. After the age of 40, the eye's ability to adapt begins to decline with age. At this time, we can experience that we can no longer perform our usual close-up activities from the usual distance, especially in poor lighting. In other words, from now on, those who can see well at a distance without an aid need a near, so-called reading correction, while those who previously wore some kind of diopter for distance (farsighted, nearsighted, people with cylinder deviation) need to use a new, different diopter correction for near in order to achieve quality vision. To put it simply: after the age of 40, different diopter corrections are required for different distances in order to see clearly. This can cause many inconveniences in everyday life.
Improving the visual acuity of people in the above age group at distance and, if possible, near, i.e. making them partially or completely correction-independent, can be achieved through a variety of surgical procedures, taking into account individual needs. However, it is important that those affected do not have unrealistic expectations, as some degree of compromise is required with every intervention.
LASER VISION CORRECTION
With laser vision correction procedures – which are performed on the front surface of the eye, in the cornea – the diopter used for distance can be abandoned primarily. So after the surgery, in addition to good distance visual acuity without diopters, some correction will be needed for near work in the long term after the age of 45. Thus, for patients who primarily need to see well at a distance in everyday life and can accept near correction, this procedure, performed on both eyes, may be a suitable choice.
MONOVISION CORRECTION
Laser treatment also allows one, so-called dominant eye, to be corrected for distance vision and the other, non-dominant eye, for near vision. This is otherwise known as monovision correction. The procedure can result in the patient not needing glasses for both distance and near vision, but the ability to see with both eyes together and see in space is slightly impaired. This is not easy for everyone to get used to, so it is worth trying out contact lenses before this type of surgery to see how the patient can cope with the planned diopters in everyday life.
Whether the surface (PRK) or flap (LASIK) type of laser procedure is suitable for a given case is influenced by a number of ophthalmological and general factors, similar to those in the younger age group. This is determined during a suitability assessment.
LENS SURGERY
If someone requires independence from glasses for both distance and near vision and would like to maintain the ability to see with both eyes together, as a result of the above, we cannot achieve the desired result with laser surgery in the aforementioned age group. In such cases, the so-called refractive lens exchange may be considered as a solution for suitable patients. In this case, the intervention does not take place on the front surface of the eye, but the biological lens inside the eye is removed and an artificial lens is implanted in its place. The technique of the procedure is identical to cataract surgery, which is the most performed ophthalmological surgery worldwide. The artificial lens implanted during the intervention is preferably multifocal. This type of artificial lens can ensure that visual acuity is good for distance, near and semi-near, or also known as monitor distance, without correction. Getting used to the phenomena, the so-called Adaptation, or brain adjustment, usually occurs quickly, the sooner the more glasses-free the patient's main goal was. Lens replacement can be a lifelong solution for those who are eligible.
For the sake of completeness, it should be mentioned that this type of intervention also offers the possibility of the aforementioned monovision correction. This means that the patient does not receive a multifocal lens, but a so-called monofocal lens, and with its help, the dominant eye is adjusted to have good visual acuity for distance and the other eye for close-up. Of course, here too, the weakening of the ability to see with both eyes must be accepted as a compromise.
IN SUMMARY
From the above, it can be seen that there are many options for significantly improving visual acuity even after the age of 45. The available surgical techniques are suitable for meeting a wide range of needs, and a thorough ophthalmological examination and personal consultation can help to establish an individualized treatment plan. In this way, we can significantly improve the quality of life among patients who require it, in line with today's expectations.
If you also desire a life without glasses and we have piqued your interest, apply to our Ophthalmology Center for a suitability test – using one of our contact details at the bottom of the page – where our specialists will help you choose the most ideal personalized solution!
