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After the age of 40 years the natural lens of our eye becomes less flexible, losing its ability to change shape and to focus on objects close at hand. This process is called presbyopia and although it affects different people at different ages past 40 years eventually everyone will require help with reading glasses or corrective lenses unless they are naturally short-sighted when they can remove their distance vision glasses to read without help. Presbyopia can occur in the presence of normal vision or any other refractive error e.g. myopia (short-sight), hyperopia (long-sight) or astigmatism. Laser vision correction for presbyopia has traditionally centered on producing monovision, correcting the dominant eye for distance vision and the other eye for near and many people will have experienced this through their contact lens use. Laser blended vision using PRESBYOND® offers a number of advantages to monovision by customizing the correction for each eye to fine-tune depth of focus and creating a blend zone that preserves binocular vision providing more natural vision. A refractive error can be corrected at the same time so PRESBYOND® can be used in conjunction with correction for myopia, hyperopia and astigmatism within certain limits of correction. The correction to each eye is usually applied through the LASIK procedure but can also be applied by advanced surface ablation.
On the day you come into the clinic we will run through the procedure again with you so that you will be reassured about the steps. Allow 2-3 hours to be at the hospital so that you have plenty of time. Like SMILE®, LASEK and LASIK, PRESBYOND® is not painful and takes around 5-10 minutes per eye to complete, you will be in the laser room itself for around 20-30 minutes and will have a nurse with you throughout.
We will apply drops to numb your eyes and cover the eye that is not being treated. A small device is used to prevent the eye being treated from blinking although it will feel to you as if you are blinking normally. The Visumax® femtosecond laser will dock and you will feel gentle pressure but no pain because the Visumax® uses a curved surface to mirror the shape of your cornea. For this reason, it is the gentlest of all femtosecond lasers and you will be able to see a green flashing light during treatment to hold your gaze. Creation of the LASIK flap takes less than 10 seconds, this will be checked and the procedure repeated if both eyes are to be treated. The couch will glide across to the Mel® 90 excimer laser so that the flap can be gently lifted and treatment completed. Most prescriptions will require much less than a minute to correct and you will be unable to feel the laser although you will hear a sound during treatment. Once completed, the flap is floated back into position and checked before eyedrops are applied.
After surgery, you will rest for a short while and be provided with refreshments before going home. Your eyes will feel slightly gritty and will be sensitive to light so we recommend that you bring (non-prescription) sunglasses with you. We will provide you with antibiotic and anti-inflammatory drops to use as well as a reminder of your does and don’t instructions and also some comfortable eye protection to wear overnight. We ask you to be careful not to rub or touch your eyes and to avoid showering or getting tap water into your eyes for the next few days.
You will be able to see immediately after treatment is completed and you sit up although your vision will be blurry. You can then expect to see continual improvement in your vision over the first day or two although your vision will fluctuate which is normal. Your vision will then continue to improve and stabilize over the next weeks.
We suggest that you arrange transport home from the hospital. You may experience mild discomfort but there should be no pain. After this point you should notice your vision improve quickly and can get back to your normal routine. We will ask you to start using your eyedrops later on the day of your procedure. If your eyes feel dry or gritty we advise you to use plenty of the artificial tears we will provide you with to keep them well lubricated, particularly if you are using screens.
We will invite you back for a check-up within the next 48 hours and then again at intervals thereafter, typically 1-2 weeks then at 3 months and 1 year. You can return to normal activities such as exercise and swimming after a week but we can advise you specifically about any activity you wish to resume.
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