Presbyopia (LBV)

Presbyopia – occurs at around 40–45 years of age and involves the loss of accommodation of the eye. There are several theories about the reasons for the loss of accommodation. The most popular of these involves the loss of elasticity of the lens of the eye, which causes a decrease in the ability of sharp vision of close objects.

Symptoms of Presbyopia

Eye accommodation disorders cause blurred vision for near distance. The first signal of presbyopia is mostly a difficulty in reading small text in a newspaper or book, as well as in other visual work at near distance. People with presbyopia are beginning to move the read text away from the eyes in order to capture a sharper vision. But when the distancing of the text becomes uncomfortable or inadequate, it is necessary to reach for reading glasses. Those who have so far been diagnosed with hyperopia need stronger “plus” eye glasses. People with a small “minus” impairment at a distance can read at near distance without eye glasses. However, in the case of people with myopia there is a need to use reading glasses with slightly smaller “minuses” than those used for far vision.

For a group of people affected by presbyopia there are still developed new solutions to improve the comfort of near vision and to reduce dependency on reading glasses.

Presbyopia correction

MAVIT MC uses the innovative method of LBV with micro-monovision in patients who want to undergo laser vision correction with simultaneous presbyopia correction. In this method, we use an excimer laser, which operates with the aberrometric and topographic platform. We have this equipment since 2008, so many years of experience in working with this system gave us the motivation to better use of its features, which resulted in an extension of the offer for laser vision correction with presbyopia correction. With the mentioned devices we can design a non-linear aspherical ablation profile, which is based on the patient’s age, refraction, pre-operative spherical aberration, corneal topographic maps and anisometropic tolerance. The essence of the method LBV is to increase the depth of field for each eye through the use of original, non-linear and aspherical profile of laser ablation. Correction of one eye (the dominant one) is determined for far vision, while leaving a slight myopia in the non-dominant eye (micro-monovision). The brain, by combining the two images, creates a zone in which the image is in focus for both eyes.

Therefore, the procedure using the method LBV with micro-monovision involves a harmonious adjustment of vision of the eyes in order to obtain sharp image both for far and near vision. The unquestionable advantage of this method is preservation of the spatial vision (stereopsis) with minimal side effects in far vision compared to the commonly used monovision (where one eye is typically for far vision, and the other one for near vision, without good vision in the transition zones). The LBV method is accepted in case of 97% of patients. In order to ensure that the LBV with micro-monovision is an appropriate method in each case, first we perform a lenticular test that allows to predict the effects of the procedure.

Qualification

For the procedure there are qualified people who:

  • are under 40 years of age
  • have a vision impairment in the range
  • have noticeable difficulty in near vision
  • enjoy good general health.

The final decision about the possibility of performing the LBV procedure can be made by a physician after a thorough, comprehensive eye examination.

Contraindications for performing laser correction of vision impairment  with the LBV method are: diabetes, connective tissue diseases – the so-called collagenoses, e.g. rheumatoid arthritis, scleroderma, lupus, polyarteritis nodosa, Sjögren’s syndrome, autoimmune diseases e.g. thyroid diseases, Hashimoto’s thyroiditis, Graves’ disease, diseases with the weakening of immunity, atopy and severe allergies, acne rosacea, active infectious diseases, individual tendency to form hypertrophied scars, called keloids, implanted pacemaker.

This procedure cannot be performed in people: after viral keratitis, with retinal detachment, herpes zoster ophthalmicus or glaucoma, cataract, some retinal degenerations, keratoconus or other corneal degenerations, dry eye syndrome, vascular diseases of the eye, degenerating high myopia, nystagmus.

LBV procedure should not be performed also in people whose profession requires a very sharp far vision (pilots, drivers).

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