Supracor Lasik – Presbyopia

  • LASIK procedure that corrects the need for reading glasses (Presbyopia)
  • Full range of correction for distance, intermediate and near
  • Available for nearsightedness, farsightedness and astigmatism
Finding it difficult to read ? Have you lost the joy of reading and now tormented with having to wear stronger and stronger reading glasses ? You have a condition called presbyopia and the good news is this can be corrected using Supracor Lasik laser eye surgery.

Why do I have difficulty reading ?

As we get older the lens in our eye that provides fine focussing for near becomes harder and harder as stops moving as much without considerable effort. This means our fine focus disappears and we have to wear initially mild powered reading glasses to read up close. As time goes on this gets worse and stronger glasses are required and eventually intermediate vision is a problem and eventually some wind up with varifocal lenses. Hyperopic patients (farsighted) are affected at an earlier age than others. So with all the advances in Lasik Laser eye Surgery, is there no option for Presbyopia correction ?
John Hyett – Centre for Sight patient

“Finally, I am looking forward to this summer holiday, relaxing on the beach, reading a novel with sunglasses as if I were 30 again!”

John Hyett
Centre for Sight Patient

Options for the correction of presbyopia

Multifocal IOL

Laser lens replacement with multifocal intraocular lens (IOL) is an excellent and reliable option that provides good visual acuity at distance, intermediate and near in both eyes. This is suitable for those who are nearsighted and in their mid 50s or farsighted and over 50 and in patients who require cataract surgery. There are several options of multifocal iol implants and trifocal lenses which Centre for Sight introduced to the UK in 2011 reliably provide good vision at all distances. More information on laser lens replacement can be found here

Supracor Lasik

What about those in their early 40s to 50s who are struggling with glasses for near ? Laser lens replacement is in our view not a good option because of the unacceptably high risk of retinal detachment in young patients. A good option available presently is Supracor Lasik, which is a Lasik procedure (Laser in situ keratomileusis) with the creation of a flap using the femtosecond laser and performing an excimer laser treatment with a multifocality on the cornea. This provides vision at near and intermediate without excessive compromise of vision at distance. The procedure is typically performed in the non-dominant eye only with regular aspheric or wavefront lasik in the dominant eye. With both eyes open, distance vision is good in both and slightly better in the dominant eye. Intermediate is good in both eyes and near vision better in the non-dominant Supracor treated eye. This Supracor blended vision works well in many patients and suitability is determined at consultation by a refractive surgeon. It is an excellent option for those who are used to Monovision with their contact lens where one eye is adjusted for near and the other for distance.

Corneal Inlays

These are inlays that are implanted under a corneal flap and using different mechanisms improve near vision. All inlays using a plastic material have fallen out of favor and Centre for Sight pride themselves in never using this option. Our view has been the cornea does not like anything foreign embedded within it except corneal tissue or corneal collagen. An inlay that really does work well is the Allotex Transform corneal graft inlaywhich is a microscopic layer of corneal tissue implanted under a corneal flap. Centre for Sight has been involved in a study of this option and outcomes have been excellent with the cornea behaving very much like one that has had Supracor Lasik blended vision. This option will hopefully be commercially available in the near future.

Monovision

This is where one eye is adjusted for distance and the other for near. This has been quite a popular option, but not all patients can get used to using one eye at distance and the other at near. Contact lens prescriptions and Laser surgery has been used to create this option in the past, however now with Supracor which increases the depth of focus, this is not performed as often.

How does IntraLASIK Supracor work?

This is a Lasik / Intralasik procedure where a corneal flap is created using the Intralase femtosecond laser. The flap is lifted and the Bausch + Lomb – Teneo excimer laser is used to create a customised profile on the cornea. The profile has a small area in the centre of the cornea which is a little steeper and provides the near vision focus as well as an increase in asphericity which improves visual quality. In summary near vision is provided along with the benefit of better quality vision at distance! Visual outcomes are excellent. The profile of the treatments both in hyperopic and myopic presbyopia

Hyperopic Supracor treatment – laser profile

Hyperopic Supracor Treatment

Myopic Supracor treatment – laser profile

Myopic Supracor Treatment

How does Supracor differ from PresbyLASIK advertised by others?

PresbyLASIK uses a very different profile on the cornea, the side effect of which is the inducement of undesirable aberrations. Apart from unreliability of correction, Presbylasik also results in night vision problems such as halos and glare. Supracor on the other hand does not induce these visually disturbing aberrations but still provides distance, intermediate and near vision.

Supracor results

These are results from the CE marking European Multicentric Study (courtesy Technolas) for Hyperopia (Farsightedness). Notice distance vision improves with time, however near vision is excellent right away and remains stable.

Distance vision
(96% see distance sc 0.8 or better (6M)

Supracor Distance Results

Near vision
(91% see near sc 0.8 or better)

Supracor Near Results

Common Questions

Will both eyes be the same?

Supracor is an “art form” and success is highly dependent on good patient selection and surgeon / ophthalmologist experience. Initially vision at near is good but distance can be compromised because distance correction is a little nearsighted. In time this improves with recovery highly variable from a few weeks to many months. For this reason the surgeon will take into consideration each individual patient, the level of correction and their immediate visual needs.

For those who are Hyperopic (farsighted), your surgeon may depending on your visual needs choose to perform a mild Supracor treatment in the dominant eye and a full Supracor treatment in the non-dominant eye. Visual recovery for distance is quicker. In Myopic (shorsighted) Supracor, the consultant might decide to only treat the non-dominant eye. Unlike Monovision or Blended vision where one eye is treated for distance and the other for near, this Laser eye surgery procedure is commonly performed in both eyes and between the two, patients enjoy visual freedom for at all distances.

Is the effect immediate?

A dramatic difference is noted immediately in terms of near vision and all patients are able to read a newspaper immediately after the procedure. To begin with the treatment does make patients a little shortsighted (-0.50D), in other words vision is slightly blurry at distance and this improves over the following weeks. Distance vision continues to improve month by month and 20/25 vision is obtained in 74% at 3 months 96% at 6 months. (Multicentric CE marking study).

How do I know if I am suitable?

Suitability for treatment requires a thorough consultation with specific investigations including the degree of Presbyopia (requirement for reading glasses). Treatment is available for those who are farsighted, shortsighted and astigmatism. Find out if you are suitable for Supracor – contact Centre for Sight to book a free consultation.

Can I be treated if I have previously had Laser eye surgery?

YES – patients who have previously had Laser eye surgery have had successful outcomes following Supracor LASIK.  Understandably those who have experienced the benefit and visual freedom from previous laser eye surgery are really motivated to stay out of glasses including readers. Supracor Lasik is an excellent option for this group of patients

Do I need to do anything special after the procedure?

Care following this type of procedure is identical to Lasik / Intralasik the details of which are found here