Can LASIK Improve Reading Vision?
Are you over age 40 and struggling to read small print with your glasses or contacts? LASIK can help with that.
Modern LASIK surgery can correct reading vision problems caused by presbyopia with a technique called monovision — where the LASIK surgeon fully corrects the refractive errors in one eye and intentionally leaves the other eye mildly nearsighted. The result: the fully corrected eye sees distant objects very clearly, and the nearsighted eye provides sharper near vision without reading glasses.
If you are considering this option, it's often wise to first try monovision with contact lenses for a short period to make sure you can adapt to the monovision experience before proceeding with monovision LASIK.
Another option is multifocal LASIK — a procedure where the laser reshapes the surface of the eye in a fashion that mimics the appearance of bifocal or multifocal contact lenses. Multifocal LASIK can reduce the need for reading glasses, but there's an increased risk of glare and halos after this procedure, which may be difficult to reverse.
Monovision LASIK is one way to improve reading vision. A corneal inlay is another.
And another presbyopia correction surgery option is corneal inlay surgery. In this procedure, a laser is used to create a small pocket in the center of the cornea of one eye, and a tiny optical device (a corneal inlay or corneal implant) is then placed in this pocket, which self-seals.
The corneal implant increases depth of focus in the treated eye — improving near vision without any significant loss of distance vision. (This is its advantage over monovision LASIK, which improves near vision but causes noticeable loss of clarity of distance vision in the "near" eye.)
Currently, the only corneal inlay approved by the FDA for use in the U.S. to improve reading vision is the Kamra inlay (AcuFocus). A second corneal inlay called the Raindrop Near Vision Inlay (ReVision Optics) gained FDA approval in 2016 but was discontinued in January 2018.
Another corneal inlay — the Presbia Flexivue Microlens (Presbia) — has received the CE mark allowing the lens to be commercially available across Europe, but it is not yet FDA approved for use in the United States. [Read more about corneal inlays.]
A corneal inlay procedure can be performed for people who have perfect distance vision without corrective lenses and just need help with presbyopia-related reading vision problems. Or it can be performed sometime after LASIK for people who also need vision correction for nearsightedness, farsightedness, and/or astigmatism.
Finally, if you've been told you have early cataracts (or you are at significant risk for impending cataracts due to your age or other factors), another excellent option is refractive lens exchange or early cataract surgery that includes implantation of a modern presbyopia-correcting IOL.
With all these options available, it's best to have a consultation with your eye doctor to help determine which surgical procedure to improve your reading vision is best for you.
About the Author: Vance Thompson, MD, FACS, is the director of refractive surgery at Vance Thompson Vision in Sioux Falls, S.D. He also is professor of ophthalmology at the Sanford USD School of Medicine, a leading researcher in technologies for laser and implant vision correction and a member of All About Vision's editorial advisory board.
Page updated February 2018