April 30, 2017
In this edition of Ocular Surgery News, the OSN Roundtable discusses how presbyopia is becoming a subspecialty of ophthalmology. In this guest commentary, Francesco Carones, MD, weighs in on the topic
Looking at the present state of refractive surgery, in which the correction of refractive errors such as myopia, hyperopia and astigmatism has become safe, accurate and precise with outstanding results for most patients, I feel that presbyopia correction still involves challenges and compromises. Think of the procedures we use to correct, let’s say, 2 D of myopia. I can count three, maybe four, surgical techniques that are currently used — LASIK, PRK, advanced surface ablation, SMILE — and all of them provide similar, excellent results. Think now of the procedures we use to correct the same amount of presbyopia, 2 D. I can count at least 10 different approaches, and none of them gives the same results. This, however, does not mean that presbyopia cannot be safely and successfully corrected. It means that each single approach has potential advantages but also downsides leading to compromises, and our challenge as surgeons is to identify for each single patient what is the best acceptable combination between advantages and compromises.