Refractive presbyopia management

Published on 08/03/2015 by admin

Filed under Opthalmology

Last modified 08/03/2015

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CHAPTER 32 Refractive presbyopia management

Introduction

Operation techniques

Pseudoaccommodative procedures

Monovision

The term monovision refers to correcting one eye (usually the dominant) to emmetropia and the other to a myopia between −1.0 and −2.0 D. which can be achieved with a variety of refractive surgical procedures (e.g. excimer laser surgery)2. In hyperopes, a steepening of the cornea with over-correction of one eye can be performed by laser thermokeratoplasty (LTK) or conductive keratoplasty (CK). All surgical techniques which can generate a unilateral myopia can be used in emmetropes.

A limitation of monovision is the lack of a possibility for correction of intermediate distance vision without simultaneously affecting near and distance vision. Model calculations resulted in little impairment of intermediary vision up to a near addition of 2 D. Before surgical treatment to achieve monovision is attempted, tolerability should be tested with contact lenses.

Multifocal excimer laser treatment of the cornea

Principle

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