Die Presbyopie, auch treffend als „Alterssichtigkeit“ bezeichnet, wird durch eine
zunehmende Verhärtung der Augenlinse ausgelöst, betrifft jeden Menschen und führt
durch den Elastizitätsverlust der Augenlinse zu einer Abnahme der Akkommodationsfähigkeit
und damit zur Notwendigkeit einer Lesebrille bzw. einer Gleitsichtbrille. Wird eine
Brillenkorrektur abgelehnt, so stellen operative Verfahren der refraktiven Chirurgie
eine Alternative dar.
Abstract
Presbyopia is caused by the loss of accommodation of the human lens due to the aging
process. Refractive laser surgery of the cornea cannot address the cause of presbyopia,
but may be used to decrease the need for glasses. There are two options typically
used and frequently combined.
The first option is monovision, more precisely “mini-monovision”, which means targeting
one eye, typically the distant-dominant eye, for emmetropia, and the other eye for
low myopia (about − 1 to − 1,5 D). The second option is the use of special ablation
algorithms which induce spherical aberration of the cornea to increase the depth of
focus in both eyes. Both options offer about a 1.5 D range of focus. If combined,
this range of focus can be further increased to provide good reading and distance
vision without glasses with slightly reduced stereopsis and contrast sensitivity only.
Both mini-monovision and significant spherical aberration are not tolerated by everyone.
It is therefore
essential to test acceptance of both prior to presbyopia-correcting corneal laser
surgery, e.g., using contact lenses. In addition, it is important to inform patients
that the effect of this surgery is not lasting, as the aging process of the human
lens continues, which results in slow changes of refraction.
In conclusion, presbyopia-correcting corneal laser surgery is an effective tool in
selected patients to reduce spectacle dependence with few side effects.
Schlüsselwörter
Presbyopie - Alterssichtigkeit - LASIK - Monovision - optische Aberrationen
Keywords
presbyopia - LASIK - monovision - optical aberrations
