So you want to see without bifocal or varifocal glasses
Presbyopia is the focusing error that occurs universally as the eyes capacity to alter its focus from distant to near objects decreases. This usually manifests after the age of 40 initially by having to read at a full arms length and as it gets worse reading glasses, bifocals or varifocal spectacles are used. The reason why everyone gets Presbyopia is due to the ageing of the natural lens of the eye, which loses its capacity to adjust focus from distant to near objects. Laser vision correction (LASIK, LASEK or PRK) can correct for distance or near vision but not both simultaneously. Thus, people in their 40's needing bifocal, varifocal or reading glasses get limited improvement from laser vision surgery. Further Laser vision surgery works by altering the focus of the cornea and hence does not alter the ageing process of the natural lens of the eye. This process ultimately results in cataract formation. In the past, various surgical options to correct Presbyopia have met with very limited success.

Presbyopic Lens Exchange (PRELEX) is a surgical procedure, designed to correct Presbyopia by exchanging the ageing natural lens of the eye for a new intra-ocular lens. This new lens could be either a Multifocal Lens (similar to a varifocal spectacle lens) or an Accommodating lens which mimics the natural lens and moves within the eye to adjust its focusing power depending on whether the eye is looking at distant or near objects. This surgery evolved from Refractive Cataract Surgery where the cataract (cloudy natural lens) is exchanged for a Multifocal or Accommodative lens. Thus, the PRELEX operation is very similar to a cataract operation but uses new replacement lens technology to restore good distance and near vision without traditional bifocal, varifocal spectacles or contact lenses. The vast majority of patients are able to function most of the time without spectacles or contact lenses while needing glasses or contact lenses for some visually demanding activities like driving, reading fine print etc. As the ageing lens is replaced, it eliminates the risk of developing a cataract and in some ways is like bringing forward your cataract operation by a few years.

An assessment of your visual needs, lifestyle, and a complete eye examination are critical factors in choosing an appropriate surgical technique for your particular eye. The eye examination includes a full assessment of the optical system of the eye i.e. Refraction, Scanning Slit Corneal Topography, Pachymetry, Keratometry and Pupillometry.

As with all surgery, PRELEX Surgery is associated with certain risks for complications. There is a wide range of complications reported but generally, there is a minute chance of a blinding complication, while the chances of ending up with worse vision after surgery compared to before are less than 1%. Your decision to have PRELEX surgery should be a positive informed decision based on an individual and accurate assessment of the potential risks and benefits.