What are the PRESBYOND risks?

Dr. Christoph Kranemann explains the risks associated with PRESBYOND.

Christoph Kranemann: The risks are not dissimilar from the risk of wearing a contact lens. The only thing, pretty much, that is risk-free is wearing glasses which is a perfectly reasonable alternative if that’s what you’d like.

When wearing contact lenses, or undergoing laser vision correction of any kind, there is a minimal risk of infection. With laser vision correction, because it is surgery and you are cutting something, there is sometimes dryness afterwards that can take a year to go away. However, as the little nerves in the cornea regrow and reform this will go away. The dryness will dissipate, but it may require some more lubrication in that first year. That is entirely normal.

Sometimes, the eye can be a tad sensitive towards the end of the year. Just like when you have a cut anywhere else, as the nerves regrow, the area is, temporarily, a little more sensitive.

There are a bunch of safety tests done, beforehand, to ensure that there is no structural weakness to the tissue. Even in 2019, the world is not 100 % perfect; there’s a possibility of some hidden weakness that can be missed. This would subsequently require some structural strengthening treatment, which is certainly possible and available.

This treatment requires excellent precision, and sometimes, the eye responds marginally differently from the best statistical calculation, what we call nomogram. We’re looking to give you the best and most exact optical range of vision possible. It is only understandable that there is going to be a small but definite chance that we will need to do a touch up at some later point. There may be a slight over, or under correction. PRESBYOND is less forgiving than a standard laser procedure. The most common side effect is that we have to do a touch up in the first three to six months afterwards. Beyond that, there’s no significant consequence.

There are two main components. One is the fact that your eyes will be slightly different. Commonly, a person will cover one eye, and then the other eye to check, even if I tell them not to do that! That’s just a natural, normal thing. Some people will snap in right away, and by the next day, they’re perfect. They don’t notice anything, and they’re functioning perfectly fine. Some people may take four weeks or so, to settle in and adapt to the fact that there is a slight difference between the eyes.

There is transiently some more dryness after surgery. It’s worse in the first few weeks. Dryness affects us most when we’re reading because our eyes are open. We blink only 10% as often than when we talk to someone, so of course, the vision may be somewhat affected by that early on. Sometimes the reading vision takes a little bit longer to kick in at first. That would be entirely normal and is really dependent on how dry the eyes are beforehand.

Soft contact lenses are full of water from your tear films, and they can make your eyes drier. Contact lenses may have created a circumstance where we’re starting out with more dryness. However, once you remove the contact lenses, over time, the dryness will improve.

We should remember that with laser vision correction based on previous large-scale studies, there is no higher risk than long-term contact lens wear. There’s no real risk of actually going blind. There could be with some surgery in the eye if we were doing something, yes, it’s a small risk. It’s variable. It depends on how dry your eye was before surgery, and whether you are used to a slight difference between the eyes. It’s entirely possible that you may be very good on the first day afterwards. You may already have the full range of vision on the first day. In the other extreme, it could sometimes take four to six weeks for it to be precisely spot-on.