Treatments for Presbyopia.

Abstract

Background: Accommodation is the eye's ability to dynamically adjust its refractive power in order to focus images at varying distances sharply onto the retina. Presbyopia is the progressive deficit of accommodation that develops as an individual becomes older. An estimated 1.8 billion people worldwide have presbyopia.

Methods: This narrative review is based on pertinent publications retrieved by a PubMed search using the terms "presbyopia," "presbyopic," "intraocular lens," "corneal inlay," and "presbyLasik," with particular attention given to prospective and retrospective studies, systematic reviews, and meta-analyses published in English or German up to February 2025. Additionally, clinical and surgical experiences from the Universitätsklinikum Frankfurt am Main (Germany) were taken into account.

Results: Many different techniques for the correction of presbyopia have been developed and studied, both nonsurgical and surgical. They differ from one another in invasiveness, the range of corrected vision, and expected optical and visual quality outcomes. Proper patient selection and precise preoperative diagnostic evaluation are prerequisites for success. The highest spectacle independence rate, of 96%, was achieved in a study with only 27 patients, in which multifocal intraocular lenses were implanted during cataract surgery or refractive lens exchange, with postoperative satisfaction exceeding 90%.

Conclusion: Presbyopia can be corrected by either nonsurgical or surgical means. However, the restoration of natural accommodation or a fully equivalent mechanism has not yet been achieved.