This vision disorder inevitably affects everyone. From the forties, everyone has presbyopia, and gradually sees their near vision deteriorate, often requiring the wearing of glasses. But if the presbyopia can not be completely corrected, operations on the other hand compensate for this progressive drop in vision. Invited Wednesday of Walk -in , on Europe 1, Damien Gatinel, surgeon-ophthalmologist, and head of service at the Rothschild Foundation, came to present the different possibilities available to patients.
When and how does presbyopia manifest?
Presbyopia occurs "when the lens, a small organ of the eye, loses its flexibility and is no longer sufficient to allow the eye to focus for close distances", explains Damien Gatinel, who explains that this vision disorder is reported on average at the age of 43.
According to the doctor, the first warning sign of presbyopia is "the difficulty that some people experience in reading small characters in a slightly dim light".
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"Presbyopia is not really corrected in surgery"
"Many" of patients want to correct their presbyopia, says Damien Gatinel, this vision disorder remaining "very debilitating". If, at present, ophthalmic surgeons "operate more people for myopia", "in word of mouth, presbyopia surgery is more successful".
In reality, an operation cannot make the view perfect, says the specialist. "We don't really correct presbyopia in surgery," he confirms, "because we don't know how to restore flexibility to the lens." But, he specifies, "we can overcome presbyopia, compensate for it".
What are the operating methods?
"There are two main families of techniques in refractive surgery. On the one hand, laser techniques, where the cornea is sculpted, and techniques where the lens is replaced by an implant," explains the guest from Europe 1. But before resorting to one of these techniques, Damien Gatinel recommends carrying out tests in order to "make sure that there are no other problems than presbyopia". For example, a "visual correction assessment", which must look at the state of the lens, its possible loss of transparency can demonstrate that the patient has cataracts, and therefore requiring the placement of an implant.
Because the state of far vision in the patient will directly influence the progress of the operation. Thus, in the case of a myopic who becomes presbyopic, "we will try to correct my myopia on the dominant eye, to correct his vision so that it is good from afar. On the non-dominant eye, we will leave a little myopia, or even all myopia if it corresponds to what the patient needs to see closely, or reduce it to a degree such that the patient can always read, "explains Damien Gatinel.
For farsighted people who cannot see near or far, "improving distance vision automatically improves near vision". In fact, "we favor vision from afar over the dominant eye, and near vision over the other". The operation also increases the depth of field of the patient's eyes.
Finally, concerning emmetropics, namely people who see very well from afar, "we are faced with a situation where we cannot restore near vision without losing a little distance vision", details Damien Gatinel. "But we will be able, on one of the two eyes, to improve a little near vision with one eye, which generally lowers the vision from afar, and we keep the good vision from afar with the other eye".
The implant technique can be applied to a patient suffering from cataracts, a vision disorder caused by a loss of transparency of the lens. "It is a good opportunity to compensate for presbyopia by using 'multifocal' implants, which allow better vision from far, near, but also at the intermediate stage", explains Damien Gatinel.