Eye Care

Lose Your Reading Glasses, Permanently

This is something we have done for many years with contact lenses. You cannot do it with glasses. It's just creates an unbalanced feeling if you have one glass that is good for distance and one good for reading. But we can also create monovision with surgical procedures, such as conductive keratoplasty (CK) and laser surgery.

Does monovision work for everyone?
Monovision works very well for many people. However, in some people, they may feel a little unbalanced or even have a change in their depth perception. So if somebody is thinking of monovision, whether it's with contact lenses or refractive surgery, the best way to decide whether it is for you is to try it with contact lenses first.

What does the laser surgery involve?
Laser surgery, such as LASIK, has now been around for more than 10 years. When we use a laser, we change the shape small part of the cornea. If we change the shape of the cornea, we can change the vision. The laser is used to cut and remove tissue, so there is a permanent change to the eye.

What is conductive keratoplasty (CK)?
In CK, we use a tiny probe that delivers radiofrequency energy to the part of the cornea called the stroma, and it shrinks that tissue, kind of like cinching a belt, to tighten the cornea and make the central part steeper. CK has become an exciting alternative for people who are presbyopic. It is minimally invasive. There is no laser. There's no cutting. There's no tissue removed. And the chances are you'll have excellent vision.

Are there people who are not good candidates for these surgeries?
If you come into laser surgery with significant dry eyes, they may get worse after the laser procedure. Sometimes patients may experience a glare or halo after the procedure, especially when driving a car.

When assessing people for either surgery, one of the things I like to find out from patients is what kind of work they do. If it's somebody who's cutting diamonds, these surgeries may not be for them. On the other hand, somebody who does interviewing—half the day they're talking to people, writing notes about the interview—they may be a perfect candidate for monovision with CK or LASIK. So it's very important for me to understand how they're using their eyes and what it is they want to be able to do to find out what's going to be good for them.

How long does it take to recuperate from these surgeries?
There is some variability in how someone is going to respond, how they're going to heal and the final result that they're going to have. For CK, there is some discomfort for at least one or two days afterwards. Pain and discomfort varies, so it is often hard to predict, but most patients are back to their normal function within the following week. Recovery from laser surgery is similar. There is a little less discomfort, but complete visual recovery takes a little while.

Why do some patients still need glasses after surgery?
One of the things you are going to discuss with your surgeon is what are the chances that you will need glasses for some activities. There are some patients who do not get full correction, so they may still need reading glasses for intensive activities. So they may have good everyday vision for driving a car around town, reading a menu. But they may want to have reading glasses for their very best vision for reading. So if they going to read War and Peace, 1,000-page book, they may want glasses to give them the best vision for both eyes.

Do people ever have to repeat the surgeries?
In general, the results are quite stable, particularly if you are just correcting moderate reading vision. With age, you may need to increase the amount of power you need. So if you correct someone for reading vision, and they're 45, they're going to need more power when they're 55, because aging continues to change your vision. So people need to realize that they may need to come back and do a little bit more because their eyes have aged.

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