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Laser Procedure Could Eliminate Need for Reading Glasses

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Maxwell routinely offers the surgery to patients over 35, but he actually doesn't recommend having it done before age 40. "Think of the eye as a camera. [To get a sharp image] the lens has to focus at a distance. The eye must do that, also. As you get older, that is harder to do. Monovision is a way of dealing with that."

Speaking at the World Refractive Symposium last month in Miami, Maxwell presented his results with monovision surgery on 129 patients who had the procedure last year. The patients ranged in age from 40 to their early 60s. After the surgeries, Maxwell and his staff followed their progress for an average of about three months.

"Our best candidates are patients 40 to 55 years of age," he says. Six patients asked to have the surgery reversed. Of those six, four were over 55. "Older patients didn't adapt as well, possibly because they need a stronger reading prescription, which creates a greater difference [in prescription strength] between the eyes," he says. "They also tended to be more satisfied with reading glasses.

"Nobody has demonstrated any significant loss of function or depth perception," he says. "It's just that some patients feel out of balance and don't like it."

Maxwell and Caster both emphasize that educating the patient on what to expect is essential. "The patient must understand that one eye is for near, one is for far, and the near eye will not be able to see clearly far away," says Caster. "That's the down side to monovision. It does not eliminate the need for glasses all the time, but it might reduce the need to 10% of the time."

"We explain that this is a compromise," Maxwell says. "We're trying to provide [the patient] with the best chance of having some function without having to put on spectacles. It's not perfect.

Still, he says, "monovision is a viable option for the well-informed patient. "

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