What is your expertise in presbyopia treatment?

In an interview, Dr Christoph Kranemann discusses his expertise in the treatment of presbyopia.

Christoph Kranemann: In one way or another, I’ve been treating presbyopia for over 20 years. We started using PRESBYOND, and we’re the first ones in North America to offer it to our patients in 2008.

Presbyopia treatment as part of cataract surgery

I started treating presbyopia as part of cataract surgery. Initially, I was performing monovision and finding it dissatisfying. I then went on to using artificial lenses that had multiple focal points that were basically for cataract surgery. – otherwise called, multifocal lenses.

I found that for some people, they worked really well. But they also had very significant downsides. A lot of the patients have issues with night glares and halos, to the extent that they don’t even drive at night or don’t feel comfortable driving at night.

Then we looked for other solutions for treating presbyopia. We came across this new treatment that was called laser blended vision. It is now called PRESBYOND. At the same time, I also changed my cataract surgery to employ the same principles that PRESBYOND employed.

Similar principles

PRESBYOND is using a slight offset between the eyes and increased depths of focus. I had already started to modify the lenses I used in different patients, to lenses with different optical characteristics. I did this based on how that lens was going to interact with the given person’s cornea.

I found that PRESBYOND was mirroring my approach for lens surgery. Using that approach – even in the cataract patients – we can get a good number of them to be free of glasses without having to use the multifocal lens. And certainly, marrying the PRESBYOND approach later with a monofocal lens will get rid of that.

PRESBYOND

We started to use PRESBYOND around eight years ago, as soon as it was first approved for use in Canada. Our first patient is still doing just fine without his glasses eight years later, without any problems. He was at the more extreme side of vision correction. He had almost four diopters of astigmatism, which is actually quite a significant amount, and a significant amount of near-sightedness. It’s worked out well.

I’ve been very happy with the solution of PRESBYOND. As I alluded to earlier, we have intermittently offered some of the other things, including one of the inlays. We’ve always been able to get patients to the desired end goal, but any of the other solutions were a lot more work and had more difficulties in the post-operative and a much longer recovery.

For the PRESBYOND and for the cataract patients, a lens-based approach has really been the best solutions in my practice. And that’s what we’re currently providing.