Laser Surgery for Myopia and Presbyopia: What to Expect

Regarding laser surgery for myopia and presbyopia?

Hello Dr.
Chuang: Recently, I heard a radio advertisement about laser surgery for myopia and presbyopia.
Myopia can be corrected with laser treatment, but presbyopia tends to change with age, requiring different prescriptions for reading glasses.
After undergoing laser surgery for myopia and presbyopia, if there are changes in presbyopia, will I still need to wear glasses? Thank you.

Ya Ya, 40~49 year old female. Ask Date: 2013/05/03

Dr. Zhuang Yamin reply Ophthalmology

Dear Ya-Ya,
Currently, the laser surgery for myopia and presbyopia typically involves correcting one eye for distance vision and the other eye for near vision.
This way, when both eyes are open, one can see near and the other can see far, allowing for both distances to be perceived.
However, this type of one-eye-for-distance and one-eye-for-near vision may not be suitable for everyone.
It is recommended to try wearing contact lenses before the surgery, with one eye set for distance vision and the other for near vision, to see if you can adapt to this arrangement.
Additionally, the prescription for near vision may indeed need adjustments over time, and as you mentioned, you can always get glasses for correction later on.
Finally, it is crucial to undergo a comprehensive examination and evaluation before undergoing corneal laser treatment, ensuring that the curvature of the cornea and other refractive data are preserved to avoid affecting the estimation of the intraocular lens power during future cataract surgery.
Wishing you good health,
Changhua Hospital, Department of Health

Reply Date: 2013/05/03

More Info

Hello! Thank you for your question regarding laser surgery for myopia (nearsightedness) and presbyopia (age-related farsightedness). It’s great that you’re seeking to understand the implications of these procedures, especially as they relate to your vision needs.

To begin with, laser surgery, such as LASIK or PRK, is primarily designed to correct refractive errors like myopia, hyperopia (farsightedness), and astigmatism. These procedures reshape the cornea to improve the eye's ability to focus light onto the retina, thereby reducing or eliminating the need for glasses or contact lenses for distance vision. However, when it comes to presbyopia, which typically begins to affect individuals in their 40s, the situation is a bit more complex.

Presbyopia is a natural part of aging that affects the eye's ability to focus on close objects. This condition arises due to the hardening of the lens inside the eye, which reduces its flexibility. While laser surgery can effectively correct myopia, it does not address the underlying changes in the lens that cause presbyopia. Therefore, even after undergoing laser surgery for myopia, you may still require reading glasses or multifocal lenses as you age.

In recent years, there have been advancements in laser techniques aimed at addressing both myopia and presbyopia simultaneously. One such technique is called "monovision," where one eye is corrected for distance vision and the other for near vision. This approach can help some patients reduce their dependence on reading glasses. However, it may not be suitable for everyone, as it can affect depth perception and may take some time to adjust.

Regarding your question about whether you would still need glasses after laser surgery if your presbyopia changes, the answer is likely yes. As you age, your eyes will continue to undergo changes, and you may find that you need to wear reading glasses or bifocals to see clearly up close, regardless of the laser surgery performed for myopia.

It’s also important to note that while laser surgery can provide significant improvements in vision, it does not stop the natural aging process of the eyes. Regular eye exams are essential to monitor your vision and eye health, especially as you age. If you notice changes in your vision, such as difficulty reading or seeing up close, it’s advisable to consult with your eye care professional to discuss the best options for your specific needs.

In summary, while laser surgery can effectively correct myopia, it does not prevent the onset of presbyopia or eliminate the need for reading glasses as you age. If you are considering laser surgery, it’s crucial to have a thorough discussion with your ophthalmologist about your vision goals, the potential outcomes, and what to expect in the future regarding your vision needs. They can provide personalized recommendations based on your eye health and lifestyle.

If you have any further questions or concerns, feel free to ask!

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