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Presbyopic Lens Exchange (PRELEX)


Some patients in their 40s and 50s who don’t have a cataract, but are presbyopic, can find that using reading spectacles interferes with their daily life. They can opt for lens replacement with a premium IOL to remove the need for reading spectacles.

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Presbyopic lens exchange (PRELEX)

What is Presbyopia?

  • Definition: Presbyopia, is a natural part of aging that typically begins to affect people after the age of 40 and continues to progress until around age 65.
  • Symptoms: It manifests as a difficulty in focusing on close objects which becomes progressively worse with age. Patients often find they are holding books or mobile phones further and further away to try to read clearly. I tan also produce eye strain or headaches after long periods of close-up work.
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Causes of Presbyopia

  • Aging Process: In younger individuals, the lens of the eye is soft and flexible, allowing easy reshaping for focus. With age, the lens hardens and loses flexibility, making it difficult to focus light correctly on the retina.

Presbyopia Correction

Non-Surgical Treatment

  • Spectacles: Bifocal, trifocal, or progressive lenses are common non-surgical options.
    • Bifocal Lenses: These have two power zones for distance and near vision.
    • Trifocal Lenses: These include three power zones for near, intermediate, and far vision.
    • Progressive (Varifocal) Lenses: Offer a smooth transition between different focal lengths without distinct zones.
  • Contact Lenses: Multifocal and monovision contacts are options, each with specific designs to aid in vision correction.
  • Daily eye drops – VUITY 1.25%, Eye Drops to treat Presbyopia are liscenced in the USA and may be launched in the UK. These produce a modest improvement in presbyopia and require daily drop use.

Non-Surgical Treatment

  1. Refractive Lens Exchange (Lens Replacement Surgery)
    • Procedure: Involves replacing the aging lens with an artificial intraocular lens (IOL) for presbyopia correction. In practice, this is exactly the same as cataract surgery.
    • Benefits: Eliminates the possibility of future cataracts and does not require routine care like contact lenses.
    • IOL Types:
      • Multifocal Lenses: Provide clear vision at multiple distances.
      • Extended Depth of Field (EDoF) Lenses: Offer a continuous range of vision with reduced night vision issues.
      • Monovision/Blended Vision: One eye is corrected for distance and the other for near vision, often requiring a period of adjustment.
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