Presbyopia Surgery with Multifocal Lens replacement

Presbyopia is a very common medical condition because it is a direct consequence of aging.

As we age, just like we get wrinkles or our hair starts to turn white, the eye's lens (crystalline lens) also ages, losing flexibility. This loss of flexibility prevents the lens from properly focusing images both near and far, causing what we know as presbyopia (age-related farsightedness) and making the use of glasses necessary.

The problem lies in the fact that the use of glasses is considered uncomfortable by many people who suffer from this condition, so undergoing corrective surgery is a very appealing option. 

If the goal is to solve the issue of presbyopia, the best option is surgery with a multifocal lens.

Presbyopia, or age-related farsightedness, is the loss of the ability to focus on nearby objects. This vision problem is very common and is due to the aging of certain eye structures responsible for focusing images. 

Presbyopia, or tired vision, is therefore a normal condition that will affect us all at some point in our lives, just like getting wrinkles or having our hair turn white. It is important to clarify that presbyopia is caused by age and not by excessive use of the eyes.

The patient leaves the hospital immediately after surgery, walking out on their own feet and with the eye uncovered.

Presbyopia typically begins to appear between the ages of 35 and 50, depending especially on whether the patient previously suffered from some other type of refractive defect for distant vision. It is worth mentioning that presbyopia will not go away with time; on the contrary, as we age, it will inevitably increase. In many cases, this problem is solved with simple reading glasses, or if the patient also has difficulty seeing at a distance, progressive glasses.

Although it is normal and most people naturally start using glasses, in many other cases it becomes a limitation for both professional and personal life. 

Therefore, many people choose to address the problem to avoid wearing glasses. Rejuvenating or repairing the ocular structures whose aging causes presbyopia is not possible today. However, it is possible to trick the eye by using an intraocular lens that helps focus up close and allows the patient to significantly or completely avoid using glasses.

In these cases, the most common procedure to solve presbyopia is surgery with a multifocal lens (presbyopia surgery), which mainly involves replacing the eye’s natural lens with a multifocal intraocular lens. 

Additionally, before undergoing surgery, it is important to have a prior consultation with an ophthalmologist to decide on the most appropriate procedure to solve this troublesome problem.

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Unlike other refractive defects such as myopia, hyperopia, or astigmatism, presbyopia is directly caused by aging and the loss of flexibility of the eye's lens.

Presbyopia affects a high percentage of people over 45 years old and 100% of those over 65.

The lens, which is an ocular element located behind the iris and pupil, is what allows the eye to focus the light it perceives onto the retina, which then sends this information to the brain through the optic nerve. Once in the brain, it interprets what we know as images of reality.

As we age, a series of changes occur in the proteins that, along with water, form the lens, making it increasingly rigid and less flexible. At the same time, the muscles that hold the lens also lose flexibility. This overall loss of flexibility prevents the lens from adjusting to focus on nearby objects. A clear symptom of presbyopia is when older individuals need to move a book or mobile phone away from their eyes to read what is written.

Full visual recovery may take between 24 and 48 hours, with the patient able to return to normal activities 2-3 days after surgery.

To avoid the need for glasses, the best option is presbyopia surgery with a multifocal lens.

During these preoperative consultations, the surgeon will perform a series of tests on the patient to assess the characteristics of the eye and ensure the surgery is carried out with the utmost safety and precision. 

Usually, the tests conducted by the surgeon are:

• Thorough eye examination
• Pupilometry and intraocular pressure measurement
• Refraction with and without dilation
• Orbscan topography
• IOL Master biometry
• Specular microscopy

In addition to these ophthalmological tests, the surgeon will ask the patient for information about any previous eye surgeries and the use of medications or dietary supplements. 

They will also discuss the suitability of using monofocal, bifocal, or trifocal lenses, depending on the patient’s lifestyle. In this case, the most recommended option is the multifocal lens, being the most common.

The surgeon will prescribe antibiotic eye drops for the patient to use in the days leading up to the procedure to prevent possible infections. 

The ophthalmologist will also advise the patient not to wear contact lenses for the week or ten days prior to surgery and to avoid using cosmetics or makeup around the eye area a couple of days before the procedure.

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The surgical technique used to perform presbyopia surgery with a multifocal lens is the same as the one used for cataract surgery, called phacoemulsification.

Hospitalization is not required for this procedure, and it is performed under local or topical anesthesia, which can be administered through injections or eye drops. The patient will remain awake during the surgery but will not feel anything. 

The patient arrives at the hospital shortly before the surgery and is prepared with anesthesia to begin the procedure. The patient is placed in a special chair, and the operation begins.

1. Once the anesthesia takes effect, the surgeon will make a small incision at the edge of the cornea. 
2. After that, the ophthalmologist will insert a small probe through the incision. Upon reaching the lens, the surgeon will dissolve it using ultrasound waves emitted from the probe. It is important to remember that the lens is made of water and proteins, so its dissolution is relatively simple. 
3. Once dissolved, the remaining liquid is removed using a small cannula.
4. The next step is to insert the multifocal lens into the area where the lens used to be, using an extremely small instrument. This is possible because the materials used to make intraocular lenses are very flexible, allowing them to be folded and then inserted into the eye. Once in the area where the lens used to be, the lens is placed in the exact location. Over time, this lens will become a natural part of the eye and will be completely imperceptible to the patient.
5. Finally, the surgeon may place a series of tiny sutures in the patient’s eye to assist with the healing of the incision, although it is also possible to leave it as is and allow it to heal on its own.

The duration of presbyopia surgery with a multifocal lens is approximately 15 to 20 minutes, and the patient can leave the clinic on their own feet with the eye uncovered shortly after the procedure.

The main advantage of presbyopia surgery with a multifocal lens is that it allows the patient to lose their dependence on glasses in most situations. The use of multifocal lenses enables the patient to see at different distances without the need for glasses, unlike monofocal lenses, which only improve vision at a single distance.

Another advantage of presbyopia surgery with a multifocal lens is that it eliminates the possibility of cataracts forming, as the replacement of the natural lens with an artificial one prevents its aging.

As for the risks of presbyopia surgery with a multifocal lens, they are the same as any other ophthalmological intervention, although they are unlikely. Among the risks, we can mention problems with anesthesia, whose risk is reduced through prior patient assessment; intraocular bleeding; increased blood pressure within the eye (glaucoma); retinal inflammation; and complete or partial loss of vision.

Despite the potential risks of presbyopia surgery with a multifocal lens, it is a very common procedure that surgeons perform with great ease.

The price of Presbyopia Surgery with Multifocal Lens is all-inclusive and fixed, meaning it covers everything necessary to carry out the procedure with the highest possible safety, further guaranteed by the hospital’s quality and the specialist’s experience.

The price of the surgery with Operarme is 2.500 €, per eye. 

This price includes:

• Reservation and use of the operating room
• Postoperative check-ups during the 30 days following the procedure
• Medical fees
• Anesthetist fees
• Nursing team fees
• Surgical materials needed for the procedure, including the intraocular lens
• Anesthesia and recovery room reservation
• Medical complications insurance, which covers any potential issues that may arise, although they are very uncommon

If you’d like more information about this surgery or about how Operarme works, don’t hesitate to contact us through our contact form, by calling at +34 91 141 33 56, or request a free surgical assessment consultation with our Ophthalmology Specialists by clicking below:

Do you have presbyopia and need surgery?

Request a free and immediate appointment with our specialists

Make an appointment