Laser therapy for presbyopia


Presbyopia is the progressive, age-related loss of elasticity of the lens. One possibility to correct presbyopia is laser therapy.

How is laser therapy performed?

In the laser treatment of the eyes, the anterior part of the cornea is ablated. A thicker layer is ablated in the centre than on the outside, so that the optical properties of the cornea change. In this way, the refractive power of the eye is adjusted with very precisely working devices so that the patient can obtain almost perfect vision after the operation.

“Eye lasering” is colloquial for the special LASIK eye surgery, which stands for Laser Assisted In Situ Keratomileusis. This refers to a method by which laser light causes a change in the cornea of the eye. The laser procedure is virtually painless.

The light works with a wavelength that is not visible to the human eye, so the laser itself is not noticed. First the surface of the cornea is incised and folded to the side (so-called “flap”). Then the middle layer of the cornea is ablated to the previously calculated extent.

After thorough rinsing, the flap is folded back, thus practically closing the wound from external influences. Only a few minutes after the LASIK treatment, the patient can see clearly again. Depending on the procedure, a different number of diopters can be corrected. As a rule, up to +3.5 diopters can be corrected by laser treatment. A stronger farsightedness (+5 to +8 diopters) can be corrected by the additional insertion of an artificial lens if necessary.

What results can be expected?

The goal of laser treatment is to achieve the best possible visual performance. As a rule, you can see just as well after laser treatment as with the visual aid you used before. It should be noted that presbyopia is a progressive process. Under certain circumstances, visual performance can decrease again over time. It is possible that presbyopia and astigmatism can be corrected in one session with laser treatment.

Is laser therapy painful?

The laser treatment of the eyes is not painful. Before the treatment the eyes are anaesthetized with eye drops. The treatment is not felt. As a rule, no pain is felt afterwards. Some patients report an unpleasant feeling afterwards.

When should you have your eyes lasered?

When the eyes should be lasered for presbyopia should be discussed individually with the treating ophthalmologist.

What are the risks?

The operation on the eye is to be seen as an operation in the classical sense, even if many health insurance companies devalue it as a cosmetic operation, it still has the same danger as other outpatient operations. A hygienic environment is of great importance for the success of the operation and the technical material must also be of high quality. Good training and, if possible, many years of surgical experience are the hallmarks of a good surgeon.

A LASIK operation is only considered if the cornea is sufficiently thick. If the patient’s cornea does not meet the sufficient minimum thickness, the ophthalmologist must exclude the patient from the operation. In this case it is advantageous to be in a clinic that is not primarily looking for profit, but has a university rather than private background and thus a guaranteed quality standard for the result.

Individual reasons such as drug intolerance or a risk of infection can also speak against the operation. Presbyopia worsens over the years. So if you have your eyes lasered at the age of 50 in order to regain perfect visual acuity, your near vision may deteriorate again in the following years.

If the corneal thickness of the eye allows it, a new operation is then possible, or reading glasses are needed again as before the operation, so in the end there is no profit from the operation. The cost of laser eye surgery depends on the location and institution of the operation and can vary greatly. In Germany you should expect 1500 to 2500 Euros per eye, because especially for the gentler and more precise Femto-LASIK method the costs are higher.

If laser surgery on the eye is being considered, you should make an appointment at a nearby eye clinic. These are available in almost every major city in Germany, even if the reputation of the clinic varies from city to city. As the statutory health insurance companies consider the operation as a cosmetic procedure, they do not cover the costs of the operation.

With private health insurance companies, on the other hand, the situation is very different. There are supplementary vision aid insurance plans that include one-time costs for laser eye surgery. In this case, a subsidy of up to 1000 euros is granted.

The costs for a laser treatment can be calculated at 1500 to 2000 Euros per eye. As a rule, the costs are not covered by statutory health insurance. If you have private insurance, you should check with your health insurance company before a planned laser treatment to see if and which costs are covered.