Refractive surgery: The monovision approach to presbyopia

Presbyopia affects an estimated 10.4 billion people globally and, as eye care providers, we are faced with the daily challenge of finding the best solution for our presbyopic patients. There are numerous approaches for treating presbyopia, each has its own benefits and limitations.

Current solutions for presbyopia correction include spectacles, contact lenses or refractive surgery. In the past few decades, with advances in technology, patients have become far more discerning with the type of visual solutions that are presented to them with more and more patients exploring the option of surgical solutions.

Current presbyopic surgical methods include refractive surgery of the cornea or crystalline lens (intralenticular femtosecond laser ablation, corneal inlays, presby-LASIK techniques and monovision); natural lens replacement with multifocal or monofocal monovision intraocular lens implants; modification of the sclerociliary complex (scleral implants or scleral ablation).¹