Surgical Reversal of Presbyopia
Surgical Reversal of Presbyopia (SRP) is a non-laser surgical procedure that treats a normal result of the aging process, the reduced ability of the older eye to focus at close range. Affecting almost 100 percent of those over the age of forty, presbyopia has been traditionally treated with reading glasses, or if the patient is also nearsighted, bifocals. This new surgical treatment is a painless, 45-minute procedure that involves the placement of tiny implants into the sclera, or white portion, of the eye. These implants compensate for the growth of the lens that occurs throughout a person's life. The growth is hypothesized cause of a loss of close focusing ability later in life.
SRP is not yet approved in the United States but current clinical trials overseen by the Food and Drug Administration (FDA) are obtaining good results. Currently, the only way to have this surgery done is to participate in a clinical trial or travel abroad, where either a foreign surgeon or a travelling U.S. trained surgeon will perform the surgery.
Surgical Reversal of Presbyopia is an expensive procedure. The cost of SRP will vary depending on the location, faclity and other expenses. Usually this procedure is not covered by insurance.
*Presbyopia usually occurs beginning at around age 40, when people experience blurred near vision when reading, sewing or working at the computer.
The Surgical Reversal of Presbyopia is a procedure with Lon-term results.
- What are the most common benefits of this surgery?
- How is the procedure performed?
- How long does the surgery take?
- Where will the procedure be performed?
- How much pain is there?
- What can I expect after the procedure?
- What is the recovery period like?
- What is the long-term outcome like for most people?
- Ideal Candidate:
- Other important information
- Risks and Limitations:
What are the most common benefits of this surgery?
After surgery, reading glasses or bifocals are no longer needed to see close objects. Thus, this surgery improves lifestyle by freeing people from the need to wear glasses for close work such as reading a book, doing needlework, or working at the computer. The procedure also results in psychological advantages, as reading glasses are strongly associated with older persons. Many people having this surgery have both personal and professional reasons for wanting to look younger -- such as actors or salespeople.
How is the procedure performed?
SRP is done by placing a number of small, inert inserts into the sclera, or white portion of the eye. After the application of topical anesthesia, the surgeon uses a diamond knife, guided by a computer, to cut four small tunnels in a circular pattern around the sclera. The inserts are place in the small tunnels. After the inserts are in place, the outer portion of the eye is surgically stitched closed over the openings.
How long does the surgery take?
The surgery takes about 45 minutes per eye. For the clinical trial only one eye is done. If performed abroad both eyes can be done in one operation. The procedure is performed on an outpatient basis, with the patient returning to their home or hotel the same day.
Where will the procedure be performed?
The surgery is performed in a hospital operating room.
How much pain is there?
The local anesthesia administered at the beginning of the surgery takes care of any pain during the formation of the tunnels, placement of the inserts, and closing of the tunnels. Any residual pain during recovery can be relieved using over-the-counter pain medication.
What can I expect after the procedure?
The eye or eyes are covered overnight with a patch, but this can be removed the next day. Eye drops are administered for several weeks after the surgery to keep the eyes moist and prevent infection. The ability to see close objects is not instantaneous, as the muscles of the lens must be retrained. Eye exercises are done, using a card provided by the doctor, to re-establish the ability of the eye to focus close up.
What is the recovery period like?
The eyes are fully healed a few weeks after the surgery. The eyes can remain red for this time period, but this symptom general resolves itself once healing is complete. The surgery is readily reversible in the unlikely event that serious complications result.
An important part of the recovery period is the retraining of the muscles that control the lens to flatten it again. This involves doing eye exercises approximately five minutes a day for several months after the surgery. The improvement is gradual for most people, with optimum reading ability about two to three months after the surgery, although it can be sooner with some patients.
What is the long-term outcome like for most people?
The surgery is close to 100 percent effective for restoring everyday close focusing skills, such as reading a newspaper. Extremely close work -- very fine needlepoint or working with miniatures -- may require glasses in some people, but many can achieve even that fine of focus after the surgery. Because the lens continues to grow, the surgery is not permanent, but it is estimated that the effects of the surgery will last for at least 25 to 30 years.
SRP is a surgical treatment for presbyopia, the type of farsightedness that often develops between the ages of 40 and 50. It is not a treatment for hyperopia, the farsightedness that is related to lens shape and is commonly present in much younger patients. Recently, the FDA approved the LASIK (or excimer laser) treatment, well known for its ability to eliminate myopia, or nearsightedness, as a treatment for hyperopia. An examination by an ophthalmologist can indicate whether a particular patient is a candidate for SRP or should be investigating a laser treatment, such as LASIK.
Furthermore, if the patient is participating in a clinical trial, there are additional requirements beyond exhibiting symptoms of presbyopia. These criteria include age between 50 to 65 years old, good unaided vision in each eye, general medical and eye health, and the ability to return for regularly scheduled follow-up visits for data collection over the course of two years, among other requirements. There are also a limited number of openings in the trial that is governed by calendar year. For many doctors involved in the trial, there is a waiting list for participation.
Other important information
If you are planning on having the surgery abroad and performed by a foreign-trained surgeon it is particularly important to investigate the background of your doctor. You can request their professional record from the country's licensing agency.
Risks and Limitations:
As with any invasive procedure, complications, such as infection, can result. A common complication specific to SRP is a temporary reduction in the ability of the eye to tear. Although the cause of this is unknown, it can be treated using drops, and usually goes away on its own a month or two after the surgery. Other side effects that doctors have seen are temporary redness of the eye, excessive tearing, and sensitivity to light.
The information on this web site is only intended as an introduction to this procedure and should not be used to determine whether you will have the procedure performed nor as a guarantee of the result. The best method of determining your options is to consult qualified surgeons who are able to answer specific questions related to your situation.
*Disclaimer: Source: http://www.allaboutvision.com/conditions/presbyopia.htm. Most surgeons offer convenient payments plans for this procedure. Cost does not include anesthesia, operating room facility, hospital stay, and other related expenses. Costs may also vary depending on location.