Presbyopia treatment options

54and56

Hi all,

NOT looking for any advice, just to get that out of the way!!

Looking for pointers to where the Pro's and Con's of the current treatments/procedures to correct Presbyopia can be reviewed?

I'm looking at the usual service providers in Dublin and would like to get a better (preferably independent) perspective on the various techniques such as the insertion of Presbia Flexivue Microlens or the Kamra Inlay procedure and any feedback people here who have had the various procedures may have including whether the procedures provide a permanent correction or not. These two articles are the best I can find but they're aimed at practitioners rather than patients/users.

I will get a professional consultation before I decide on anything but being the commercial cynic I am I always take "advice" from someone looking to sell me something with a pinch of salt and like to validate it independently.

In my experience, albeit in other fields of professional services, it is amazing how strong the correlation is between what the professional advises is "best" for you and the product or service they are motivated to sell for quota, profit margin, reduced stock/capability or other reasons.

Hope this doesn't infringe the thread charter in any way.

Cheers.

blackeyedpeat

Across the board there is currently no outstanding surgical correction for presbyopia be it monovision, inlays or lens implants.
Surgical success with any of these is about 85% and above with satisfaction rating of fractionally above/below 70%.
The key to all of this is managing the patient expectation and appropriate patient selection for suitability.
So enjoy the benefits and live with the limitations.
In general clinics will be reluctant to offer this type of correction to brain surgeons and rocket scientists but a retired lady who lunches is a good candidate. Most people fall somewhere in between.
Do your research on the method and the surgeon.

54and56

blackeyedpeat wrote: »

Across the board there is currently no outstanding surgical correction for presbyopia be it monovision, inlays or lens implants.
Surgical success with any of these is about 85% and above with satisfaction rating of fractionally above/below 70%.
The key to all of this is managing the patient expectation and appropriate patient selection for suitability.
So enjoy the benefits and live with the limitations.
In general clinics will be reluctant to offer this type of correction to brain surgeons and rocket scientists but a retired lady who lunches is a good candidate. Most people fall somewhere in between.
Do your research on the method and the surgeon.

Thank you.

I had a consultation/assessment with one of the Optilase clinics on Monday and the upshot is they are recommending single eye Lasik treatment to restore my near vision. The assessment process appeared fairly comprehensive to me (as a lay person) and took about an hour in total. At the end I had a contact lens inserted in my weaker eye (the one which will be treated if I go ahead) as that mimic's the effect of the Lasik treatment and gives me a feel for how things will be post the treatment. I didn't think I'd ever let a contact lens near my eye but once it was popped in it feels fine, I forget it's there most of the time.

With the contact in I'm experiencing improved near vision e.g. can read things on my phone I'd previously have to put glasses on to read but my overall vision seems to be a bit blurred which I'm guessing is a result of my right (stronger) eye struggling to adjust to its new role as the eye which will be relied on for distance vision. The lens come out tomorrow and then it's up to me to decide if I want to go ahead with the Lasik procedure or not.

The fly in the ointment however is that during the assessment the clinician identified what looks like macular degeneration in my left eye which is the one proposed for the Lasik treatment so I need to go to an ophthalmic surgeon for a consultation first.

Never a dull moment!!

makeorbrake

@Je_Suis_Jean: How did this all pan out for you?

I just had an assessment for Lasik but ended up with an option of Lasik or refractive (lens exchange) surgery (to replace lens with prosthetic lens). Because I've got Presbyopia, they said Lasik would work for 7 years - whereas the refractive surgery would last a lifetime...BUT comes at 6x the price and has a higher degree of risk (risk of infection).

I'm thinking maybe I'll kick the can down the road....perhaps they will get more refined with the technique. They assured me that although relatively new, the tech was well founded but it's probably best to let it lie for a few years, have lasik for right now and see where we're at in 7 years time.


Decisions, decisions...

54and56

makeorbrake wrote: »

@Je_Suis_Jean: How did this all pan out for you?

I just had an assessment for Lasik but ended up with an option of Lasik or refractive (lens exchange) surgery (to replace lens with prosthetic lens). Because I've got Presbyopia, they said Lasik would work for 7 years - whereas the refractive surgery would last a lifetime...BUT comes at 6x the price and has a higher degree of risk (risk of infection).

I'm thinking maybe I'll kick the can down the road....perhaps they will get more refined with the technique. They assured me that although relatively new, the tech was well founded but it's probably best to let it lie for a few years, have lasik for right now and see where we're at in 7 years time.


Decisions, decisions...

Hi Makeorbrake,

Sounds like you have a tricky decision to make!!

It turned out I didn't have macular degeneration so I ended up having single eye Lasik in the Wellington Eye Clinic in the Beacon Consultants Clinic who I couldn't be happier with. I found them incredibly professional and supportive.

What's right for you isn't something I can comment on I'm afraid :-(

makeorbrake

Je_suis_Jean wrote: »

What's right for you isn't something I can comment on I'm afraid :-(

Of course - that's assumed. It's just always interesting to see how things fared out for others in the same category (but of course still a totally different set of circumstances).

I put off lasik for 10 years because of the risk - and the risk is minuscule but I still have had difficulty in weighing that up against the fact that we only get one set of peepers. :-)

I'm overseas (in the country where Lasik originally was developed as a surgery) - and had recommendations for 2x clinics. I guess they threw me a curve ball this morning. It's not really the cost per se (although it is considerably more expensive) - it's the risk and also the fact that who knows what improvements they may have made in 7 years.

There's one side of me just wants it sorted - and if it was just a case of handing over the $, then it would be done - but these things are not so simple. I wasn't going to bother but I'm going to take a little bit more time - so I'll speak with the other clinic and let them make an initial assessment - as much as to inform myself as anything else. Will be interesting if they disclose a bit more and if they come up with the same prognosis. Time will tell...


Anyways, just had two young fellas mow me down on the street with a motor bike and I got to dust myself off and walk away! Risk is a human condition but I certainly got the right side of it today. Back to this bottle of red to steady the nerves!

54and56

makeorbrake wrote: »

Of course - that's assumed. It's just always interesting to see how things fared out for others in the same category (but of course still a totally different set of circumstances).

I put off lasik for 10 years because of the risk - and the risk is minuscule but I still have had difficulty in weighing that up against the fact that we only get one set of peepers. :-)

I'm overseas (in the country where Lasik originally was developed as a surgery) - and had recommendations for 2x clinics. I guess they threw me a curve ball this morning. It's not really the cost per se (although it is considerably more expensive) - it's the risk and also the fact that who knows what improvements they may have made in 7 years.

There's one side of me just wants it sorted - and if it was just a case of handing over the $, then it would be done - but these things are not so simple. I wasn't going to bother but I'm going to take a little bit more time - so I'll speak with the other clinic and let them make an initial assessment - as much as to inform myself as anything else. Will be interesting if they disclose a bit more and if they come up with the same prognosis. Time will tell...


Anyways, just had two young fellas mow me down on the street with a motor bike and I got to dust myself off and walk away! Risk is a human condition but I certainly got the right side of it today. Back to this bottle of red to steady the nerves!

Sounds like dodged a bullet today, enjoy the bottle of red.

Ref risk etc. Would one option be to have low risk (relatively) low cost LASIK surgery now and add the effect of that wears off in 7 years time go for the lens replacement surgery by which time it should be much more established and therefore low risk and it'll likely be much cheaper?

makeorbrake

Je_suis_Jean wrote: »

Sounds like dodged a bullet today, enjoy the bottle of red.

Ref risk etc. Would one option be to have low risk (relatively) low cost LASIK surgery now and add the effect of that wears off in 7 years time go for the lens replacement surgery by which time it should be much more established and therefore low risk and it'll likely be much cheaper?

Yes, I think that's the logical conclusion - unless the 2nd consultation with the other Clinic throws up some other info / circumstances.

54and56

makeorbrake wrote: »

Yes, I think that's the logical conclusion - unless the 2nd consultation with the other Clinic throws up some other info / circumstances.

Best of luck makeorbrake.

Don't forget to resurrect this thread in 7 years time for two reasons:-

1. To let me know if the two step approach worked out for you.

and

2. To pi$$ off some new mods :-)

makeorbrake

So just coming back to give feedback...


I went to a second clinic to get a second opinion. That doctor was of the opinion that both my near and far sight was bad. He also felt that Lasik would only facilitate doing away with glasses for 2-3 years. Despite this, he was suggesting Lasik as it is much the cheaper option.

I had discounted the idea of Lens Replacement Surgery on the basis of cost - as I had a price of USD$6000 from the first clinic. The second one was coming in at $3400 for both eyes. I had referrals for both clinics. I was not of the opinion that there was any difference in the quality of the procedure/service other than the first place having salubrious offices and being in the most upmarket part of town.

Anyways, had the procedure on Friday - was up and about yesterday. The initial signs are promising - although I really hope that my sight can sharpen a bit more. The doctor tells me there's every chance that they will over the coming days. The smallest text is still a bit out of reach - but lets see what the next few days bring.

Otherwise, the process/procedure was a breeze. I had a consultation on Tuesday, various tests on Tuesday/Weds/Thurs. and procedure on Friday. Took 2 hours but most of that was recovery from the general anaesthetic. From what I understand, it only took him ten minutes to insert the prosthetic lenses.

54and56

makeorbrake wrote: »

So just coming back to give feedback...


I went to a second clinic to get a second opinion. That doctor was of the opinion that both my near and far sight was bad. He also felt that Lasik would only facilitate doing away with glasses for 2-3 years. Despite this, he was suggesting Lasik as it is much the cheaper option.

I had discounted the idea of Lens Replacement Surgery on the basis of cost - as I had a price of USD$6000 from the first clinic. The second one was coming in at $3400 for both eyes. I had referrals for both clinics. I was not of the opinion that there was any difference in the quality of the procedure/service other than the first place having salubrious offices and being in the most upmarket part of town.

Anyways, had the procedure on Friday - was up and about yesterday. The initial signs are promising - although I really hope that my sight can sharpen a bit more. The doctor tells me there's every chance that they will over the coming days. The smallest text is still a bit out of reach - but lets see what the next few days bring.

Otherwise, the process/procedure was a breeze. I had a consultation on Tuesday, various tests on Tuesday/Weds/Thurs. and procedure on Friday. Took 2 hours but most of that was recovery from the general anaesthetic. From what I understand, it only took him ten minutes to insert the prosthetic lenses.

Thanks for the update, really useful info.

Was going to post in the smallest font possible but thought that would be too mean

Hope your recovery goes well and the final outcome is a comprehensive success!!