Laser-focused on improving vision

Dr Rob Paul performs laser eye surgery.

There’s something else certain in life beyond the well-known saying of “death and taxes”, according to Perth ophthalmologist Rob Paul – and that’s presbyopia, which forces people to wear reading glasses, or multifocals, when they hit their forties.

“It’s a natural part of ageing that affects the eye’s ability to focus up close because the lens of the eye no longer zooms in and out like it used to when you were younger,” Dr Paul explains.

“Traditionally, for somebody who came to me with short-sightedness or long-sightedness and wanted the best of both worlds – not just distance but also reading – we’d have to set one eye for distance and one eye for near.

“The problem with that is people would lose their three-dimensional vision and sometimes they can’t adapt to it. It put them out of whack a little bit and gave them an imbalanced type of visual feel. Only 70% of people really liked that setup.”

The latest advances in laser eye treatments mean this problem can now be overcome by using two state-of-the-art pieces of software called PRESBYOND and PresbyMAX.

“It’s been a real godsend,” says Dr Paul, “because it really allows for a much more accepting type of treatment post-operatively, where you’ve got over 90% patient satisfaction as opposed to 70% with the old traditional ways.

“It essentially creates more blended vision. It sets one eye for more distance and computer work, which is the dominant eye; and it sets the other eye for more reading and computer work. So, the intermediate vision is actually very good, and what we find is the eye that was set for reading still sees very well into the distance, so patients have fewer complaints in terms of imbalances or three-dimensional assessment problems.

“The two treatments change the spherical aberrations that occur naturally in the cornea. And what that basically does is, instead of giving you a set point, it allows an increased depth of focus; so it produces multiple points of vision. PresbyMAX creates a multifocal cornea and PRESBYOND creates a blended or increased depth of focus zone by changing the aberrations on the cornea.

“In patients who are very long-sighted, we tend to go with PresbyMAX. But for the vast majority, 90% of people, PRESBYOND treatment is more suitable and the far more popular procedure.”

Technology has come a very long way from two decades ago when the standard form of laser eye surgery, LASIK (laser-assisted in situ keratomileusis), used a blade to cut a flap in the cornea to correct refractive errors such as short-sightedness or long-sightedness.