Refractive surgery for presbyopia

Refractive surgery for presbyopia, still under trial,
includes :

• Monovision LASIK, i.e., one eye is corrected for distance and other is made slightly near sighted.
• Monovision conductive keratoplasty (CK) is being considered increasingly to correct presbyopia in one eye. Principle is same as for correction of hypermetropia.
• Scleral expansion procedures are being tried, but results are controversial.
• LASIK-PARM i.e., LASIK by Presbyopia Avalos Rozakis Method is a technique undertrial in which the shape of the   cornea is altered to have two concentric vision zones that help the presbyopic patient to focus on near and distant objects.
• Bifocal or multifocal or accommodating IOL implantation after lens extraction especially in patients with cataract or high refractive errors correct far as well as near vision.
• Monovision with intraocular lenses, i.e., correction of one eye for distant vision and other for near vision with IOL implantation after bilateral cataract extraction also serves as a solution for far and near correction.
• Anterior ciliary sclerotomy (ACS), with tissue barriers is currently under trial. With initial encouraging results, multi-site clinical studies are planned for the US and Europe to evaluate this technique.