Presbyopia – epidemiological background, pathophysiology, and treatment methods, including laser refractive surgery Review article
Article Sidebar
Published:
Aug 6, 2025
Keywords:
presbiopia, refractive surgery, multifocal intracocular lens, scleral procedures, presbymax, presbyond
Main Article Content
Abstract
Presbyopia is the inability to see small things up close, usually occurring after the age of 40, associated with loss of accommodation, which results in dependance on glasses when working up close. There are many different methods of correcting presbyopia, but it is still difficult to restore the status from before disease onset. The article describes the epidemiology, pathophysiology and non-surgical and surgical methods of treating presbyopia, with particular emphasis on corneal, scleral and intraocular refractive methods related to lens replacement.
Downloads
Download data is not yet available.
Article Details
How to Cite
1.
Jasina G, Kozak M, Roszkowska AM. Presbyopia – epidemiological background, pathophysiology, and treatment methods, including laser refractive surgery. Ophthatherapy [Internet]. 2025Aug.6 [cited 2026Feb.22];12(2):171-6. Available from: https://journalsmededu.pl/index.php/ophthatherapy/article/view/3078
Issue
Section
Surgery and laser therapy
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Copyright: Medical Education sp. z o.o. License allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
Address reprint requests to: Medical Education, Marcin Kuźma (marcin.kuzma@mededu.pl)
References
1. Mahrous A, Ciralsky JB, Lai EC. Revisiting monovision for presbyopia. Curr Opin Ophthalmol. 2018; 29(4): 313-7.
2. Zhang RY, Chen YG. New progress of excimer laser corneal refractive surgery for presbyopia. Zhonghua Yan Ke Za Zhi. 2022; 58(12): 1111-6.
3. Muhit M, Minto H, Parvin A et al. Prevalence of refractive error, presbyopia, and unmet need of spectacle coverage in a northern district of Bangladesh: Rapid Assessment of Refractive Error study. Ophthalmic Epidemiol. 2018; 25(2): 126-32.
4. Zebardast N, Friedman DS, Vitale S. The Prevalence and Demographic Associations of Presenting Near-Vision Impairment Among Adults Living in the United States. Am J Ophthalmol. 2017; 174: 134-44.
5. Wolffsohn JS, Davies LN. Presbyopia: Effectiveness of correction strategies. Prog Retin Eye Res. 2019; 68: 124-43.
6. Lee Y, Kim JS, Park UC et al. Recent trends of refractive surgery rate and detailed analysis of subjects with refractive surgery: The 2008-2015 Korean National Health and Nutrition Examination Survey. PLoS One. 2021; 16(12): e0261347.
7. Ahn JH, Kim DH, Shyn KH. Investigation of the Changes in Refractive Surgery Trends in Korea. Korean J Ophthalmol. 2018; 32(1): 8-15.
8. Martin H, Stachs O, Guthoff R et al. Biomechanical investigations on accommodation of the eye. Ophthalmologe. 2018; 115(8): 649-54.
9. Schachar RA, Tello C, Cudmore DP et al. In vivo increase of the human lens equatorial diameter during accommodation. Am J Physiol. 1996; 271(3 Pt 2): R670-6.
10. Coleman DJ. Unified model for accommodative mechanism. Am J Ophthalmol. 1970; 69(6): 1063-79.
11. du Toit R. How to prescribe spectacles for presbyopia. Community Eye Health. 2006; 19(57): 12-3.
12. Durrie DS. The effect of different monovision contact lens powers on the visual function of emmetropic presbyopic patients (an American Ophthalmological Society thesis). Trans Am Ophthalmol Soc. 2006; 104: 366-401.
13. Waring GO, Price FW, Write D et al. Safety and Efficacy of AG-190584 in Individuals With Presbiopia: The GEMINI 1 Phase 3 Randomized Clinical Trial. JAMA Ophthalmic. 2022; 140(4): 363-71.
14. U.S. Food and Drug Administration. NDA 214028/S-002. 2023 Mar .
15. U.S. Food and Drug Administration. NDA 217836. 2023 Oct.
16. Holland E, Karpecki P, Fingeret M et al. Efficacy and Safety of CSF-1 (0.4% Pilocarpine Hydrochloride) in Presbyopia: Pooled Results of the NEAR Phase 3 Randomized, Clinical Trials. Clin Ther. 2024; 46(2): 104-13.
17. Mahrous A, Ciralsky JB, Lai EC. Revisiting monovision for presbyopia. Curr Opin Ophthalmol. 2018; 29(4): 313-7.
18. Lim DH, Chung ES, Kim MJ et al. Visual quality assessment after presbyopic laser in-situ keratomileusis. Int J Ophthalmol. 2018; 11(3): 462-9.
19. Fu D, Zhao J, Zhou XT. Objective optical quality and visual outcomes after the PresbyMAX monocular ablation profile. Int J Ophthalmol. 2020; 13(7): 1060-5.
20. Świątek J, Wierzbowska J, Worek D. Monowizja w różnych metodach korekcji presbiopii. Przegląd Okulistyczny. 2022; 4: 7-10.
21. Luger MH, Ewering T, Arba-Mosquera S. One-year experience in presbyopia correction with biaspheric multifocal central presbyopia laser in situ keratomileusis. Cornea. 2013; 32(5): 644-52.
22. Wierzbowska J, Pniakowska Z, Roszkowska AM. Contrast Sensitivity and Stereopsis Outcomes Following LASIK Presbyopia Correction Based on the Corneal Aberration Modulation or Corneal Multifocality Induction Methods: A Systematic Review. J Clin Med. 2025; 14: 871.
23. Hipsley A, Hall B, Rocha KM. Scleral surgery for the treatment of presbyopia: where are we today? Eye Vis (Lond). 2018; 5: 4.
24. Liu YC, Hall B, Lwin NC et al. Tissue Responses and Wound Healing following Laser Scleral Microporation for Presbyopia Therapy. Transl Vis Sci Technol. 2020; 9(4): 6.
25. Schmid R, Luedtke H. A Novel Concept of Correcting Presbyopia: First Clinical Results with a Phakic Diffractive Intraocular Lens. Clin Ophthalmol. 2020; 14: 2011-9.
26. Baïkoff G, Matach G, Fontaine A et al. Correction of presbyopia with refractive multifocal phakic intraocular lenses. J Cataract Refract Surg. 2004; 30(7): 1454-60.
27. Nijkamp MD, Dolders MG, de Brabander J et al. Effectiveness of multifocal intraocular lenses to correct presbyopia after cataract surgery: a randomized controlled trial. Ophthalmology. 2004; 111(10): 1832-9.
2. Zhang RY, Chen YG. New progress of excimer laser corneal refractive surgery for presbyopia. Zhonghua Yan Ke Za Zhi. 2022; 58(12): 1111-6.
3. Muhit M, Minto H, Parvin A et al. Prevalence of refractive error, presbyopia, and unmet need of spectacle coverage in a northern district of Bangladesh: Rapid Assessment of Refractive Error study. Ophthalmic Epidemiol. 2018; 25(2): 126-32.
4. Zebardast N, Friedman DS, Vitale S. The Prevalence and Demographic Associations of Presenting Near-Vision Impairment Among Adults Living in the United States. Am J Ophthalmol. 2017; 174: 134-44.
5. Wolffsohn JS, Davies LN. Presbyopia: Effectiveness of correction strategies. Prog Retin Eye Res. 2019; 68: 124-43.
6. Lee Y, Kim JS, Park UC et al. Recent trends of refractive surgery rate and detailed analysis of subjects with refractive surgery: The 2008-2015 Korean National Health and Nutrition Examination Survey. PLoS One. 2021; 16(12): e0261347.
7. Ahn JH, Kim DH, Shyn KH. Investigation of the Changes in Refractive Surgery Trends in Korea. Korean J Ophthalmol. 2018; 32(1): 8-15.
8. Martin H, Stachs O, Guthoff R et al. Biomechanical investigations on accommodation of the eye. Ophthalmologe. 2018; 115(8): 649-54.
9. Schachar RA, Tello C, Cudmore DP et al. In vivo increase of the human lens equatorial diameter during accommodation. Am J Physiol. 1996; 271(3 Pt 2): R670-6.
10. Coleman DJ. Unified model for accommodative mechanism. Am J Ophthalmol. 1970; 69(6): 1063-79.
11. du Toit R. How to prescribe spectacles for presbyopia. Community Eye Health. 2006; 19(57): 12-3.
12. Durrie DS. The effect of different monovision contact lens powers on the visual function of emmetropic presbyopic patients (an American Ophthalmological Society thesis). Trans Am Ophthalmol Soc. 2006; 104: 366-401.
13. Waring GO, Price FW, Write D et al. Safety and Efficacy of AG-190584 in Individuals With Presbiopia: The GEMINI 1 Phase 3 Randomized Clinical Trial. JAMA Ophthalmic. 2022; 140(4): 363-71.
14. U.S. Food and Drug Administration. NDA 214028/S-002. 2023 Mar .
15. U.S. Food and Drug Administration. NDA 217836. 2023 Oct.
16. Holland E, Karpecki P, Fingeret M et al. Efficacy and Safety of CSF-1 (0.4% Pilocarpine Hydrochloride) in Presbyopia: Pooled Results of the NEAR Phase 3 Randomized, Clinical Trials. Clin Ther. 2024; 46(2): 104-13.
17. Mahrous A, Ciralsky JB, Lai EC. Revisiting monovision for presbyopia. Curr Opin Ophthalmol. 2018; 29(4): 313-7.
18. Lim DH, Chung ES, Kim MJ et al. Visual quality assessment after presbyopic laser in-situ keratomileusis. Int J Ophthalmol. 2018; 11(3): 462-9.
19. Fu D, Zhao J, Zhou XT. Objective optical quality and visual outcomes after the PresbyMAX monocular ablation profile. Int J Ophthalmol. 2020; 13(7): 1060-5.
20. Świątek J, Wierzbowska J, Worek D. Monowizja w różnych metodach korekcji presbiopii. Przegląd Okulistyczny. 2022; 4: 7-10.
21. Luger MH, Ewering T, Arba-Mosquera S. One-year experience in presbyopia correction with biaspheric multifocal central presbyopia laser in situ keratomileusis. Cornea. 2013; 32(5): 644-52.
22. Wierzbowska J, Pniakowska Z, Roszkowska AM. Contrast Sensitivity and Stereopsis Outcomes Following LASIK Presbyopia Correction Based on the Corneal Aberration Modulation or Corneal Multifocality Induction Methods: A Systematic Review. J Clin Med. 2025; 14: 871.
23. Hipsley A, Hall B, Rocha KM. Scleral surgery for the treatment of presbyopia: where are we today? Eye Vis (Lond). 2018; 5: 4.
24. Liu YC, Hall B, Lwin NC et al. Tissue Responses and Wound Healing following Laser Scleral Microporation for Presbyopia Therapy. Transl Vis Sci Technol. 2020; 9(4): 6.
25. Schmid R, Luedtke H. A Novel Concept of Correcting Presbyopia: First Clinical Results with a Phakic Diffractive Intraocular Lens. Clin Ophthalmol. 2020; 14: 2011-9.
26. Baïkoff G, Matach G, Fontaine A et al. Correction of presbyopia with refractive multifocal phakic intraocular lenses. J Cataract Refract Surg. 2004; 30(7): 1454-60.
27. Nijkamp MD, Dolders MG, de Brabander J et al. Effectiveness of multifocal intraocular lenses to correct presbyopia after cataract surgery: a randomized controlled trial. Ophthalmology. 2004; 111(10): 1832-9.