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Illustration of ZEISS Presbyopia Management: Plan, view of the software
Challenges in corneal refractive surgery

Plan

Customized visual freedom
Clinical Challenge

Plan for good visual acuity at all distances

Selecting an option that enables good visual acuity at all distances has become a common goal among patients considering corneal refractive surgical treatment who want to see clearly at far for driving and at near-to-intermediate when using their smartphones or computers. Not all refractive surgical options for presbyopia consistently meet this need.1,2

Conventional monovision corrects one eye for distance vision and the fellow eye for near vision. It can result in two distinct points of focus and leave an uncorrected gap, which is hard for the brain to adapt to the blurred image in the intermediate distance, the so called “Blur Zone”.3 Studies show that only 59% to 67% of patients could tolerate the anisometropia created by contact lens monovision.3 Multifocal LASIK approaches can provide good near and intermediate vision, but they can reduce distance vision and contrast, induce an undesirable increase in corneal aberrations, and may lead to glare and halos.2,4

Clinical Solution

Achieve clear full range of binocular vision through Laser Blended Vision

Laser Blended Vision is a LASIK-based procedure for correcting presbyopia that induces micro-anisometropia (≤1.5 D) and controls spherical aberration. Spherical aberration is a naturally occurring aberration that helps the brain to combine the images from both eyes into clear binocular vision, preserving contrast sensitivity and most of the stereoacuity, while maintaining the accommodation capacity of the natural lens.5,6 The enhanced depth of field from spherical aberration extends the range of vision in each eye, creating a “blend zone”, rather than a “blur zone”, in the intermediate range. Combining the vision from the two eyes naturally gives a clear continuous range of vision from near through intermediate to far.7,8

Graphic illustration of the Vision Range: Monovision
Graphic illustration of the Vision Range: Laser Blended Vision

Comparison of vision range between
Monovision and Laser Blended Vision

ZEISS Solution

PRESBYOND as a customized corneal refractive solution for presbyopia treatment

PRESBYOND® Laser Blended Vision from ZEISS is a customized solution planned with a software module in the Refractive Workplace from ZEISS, performed with the MEL® 90 from ZEISS, and uses a non-linear aspheric ablation profile that creates a continuous refractive power gradient over the entire corneal optical zone.9 It offers patients good quality vision with reduced dependence on glasses at all distances.10 Results from studies of patients treated with PRESBYOND show a high acceptance rate of up to 97% with a full range of good uncorrected visual acuity from near to far. These outcomes are achieved without loss of contrast sensitivity and with no significant reduction in stereoacuity.11, 13  

Image of ZEISS Refractive Workplace on a monitor

ZEISS Refractive Workplace

A software offering comprehensive and integrated remote planning for laser vision correction procedures for ZEISS Refractive Lasers. For each patient on one platform, the surgeons can conveniently and efficiently plan upcoming standard and premium procedures.

  • View and select diagnostic data for each patient on one platform to plan treatments
  • Easily enter planning parameters, quickly retrieve saved treatment plans, and digitally transfer all necessary information via ZEISS FORUM to the refractive laser devices
  • Reduce the possibility of transcription errors and enhance efficiency
Image of Dr. Sheetal Brar, MS

PRESBYOND LBV offers non-cataract patients a safe and effective treatment option for presbyopia, providing the chance of spectacle independence while avoiding intraocular surgery. Our recent studies have shown that patients experience a high level of spectacle-free reading ability postoperatively, which results in improved reading speeds and high patient satisfaction.

Dr. Sheetal Brar, MS Director of Refractive, Cataract and Cornea services, HOD of research, academics and trainings, Brar Eye Hospital, Bathinda, Punjab (2022)

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  • 1

    Fernández J, Molina-Martín A, Rocha-de-Lossada C, Rodríguez-Vallejo M, Piñero DP. Clinical outcomes of presbyopia correction with the latest techniques of presbyLASIK: a systematic review. Eye (Lond). 2023;37(4):587-596.
  • 2

    Shetty R, Brar S, Sharma M, Dadachanji Z, Lalgudi VG. PresbyLASIK: a review of PresbyMAX, Supracor, and laser blended vision: Principles, planning, and outcomes. Indian J Ophthalmol. 2020;68(12):2723-2731
  • 3

    Evans BJ. Monovision: a review. Ophthalmic Physiol Opt. 2007;27(5):417-439.
  • 4

    4. Alvarado-Villacorta R, Hernandez-Quintela E, De La Torre-Gonzalez E, Loza Munarriz C, Martinez-Zapata MJ. Surgical interventions for presbyopia (Protocol). Cochrane Database of Systematic Reviews 2023, Issue 3. Art No.: CD015711.
  • 5

    Lim DH, Chung ES, Kim MJ, Chung TY. Visual quality assessment after presbyopic laser in-situ keratomileusis. Int J Ophthalmol. 2018;11(3):462-469.  
  • 6

    Brar S, Sute SS, Bagare SN, Ganesh S. Functional outcomes and reading speeds following PRESBYOND LBV using nonlinear aspheric ablation profiles combined with micro-monovision. J Ophthalmol. 2021;2021:2957443.
  • 7

    Russo A, Reinstein DZ, Filini O, et al. Visual and refractive outcomes following laser blended vision with non-linear aspheric micro-anisometropia (PRESBYOND) in nyopic and hyperopic patients. J Refract Surg. 2022;38(5Erratum in: J Refract Surg. 2022;38(7):474.
  • 8

    Ganesh S, Brar S, Gautam M, Sriprakash K. Visual and refractive outcomes following laser blended vision using non-linear aspheric micro-monovision. J Refract Surg. 2020;36(5):300-307.
  • 9

    Mallo O. PRESBYOND Laser Blended Vision: my Experience as a patient, Ophthalmology Times Europe. September 2019.
  • 10

    Romero-Domínguez, M, Castillo-Gómez, A, Carmona-González, D, Palomino Bautista, C. Clinical assessment of defocus curves after excimer laser presbyopia surgery using aspheric ablation profiles. J Emmetropia 2016;1:39-45,
  • 11

    Reinstein DZ, Archer TJ, Gobbe M. LASIK for myopic astigmatism and presbyopia using non-linear aspheric micro-monovision with the Carl Zeiss Meditec MEL 80 platform. J Refract Surg. 2011;27(1):23-37.
  • 12

    Reinstein DZ. Advantages of Laser-Blended Vision. CRST Global Europe Edition. January 2009.
  • 13

    Reinstein DZ, Archer TJ Gobbe M: Aspheric ablation profile for presbyopic corneal treatment using the MEL80 and CRS Master Laser Blended Vision module. J Emmetropia 2011, 2(3);161-175.
  • 14

    Brar S, Ganesh S. Myth or reality? Corneal refractive surgery to manage presbyopic patients, Ophthalmology Times Europe. December 2022.