Skip to main content

Corneal compensation of presbyopia: PresbyLASIK: an updated review


The main purpose of this review is to compare and analyze the results of the main PresbyLASIK approaches; central and peripheral.


A comprehensive research was conducted in PUBMED using keywords like “presbyopia correction”, “PresbyLASIK”, “Corneal multifocality”, “Laser blended vision”. We reviewed the PresbyLASIK technique, uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected near visual acuity (UNVA), and corrected near visual acuity (CNVA), and compared the differences between the techniques.


Presbyopia is an age-related loss of accommodative amplitude; symptoms begin to appear after the age of 40. It is estimated that in 2050 there will be 1.782 billion people with presbyopia [1].

Its correction has always been challenging for the refractive surgeon. The static methods for its correction seek to increase the depth of focus, which include: monovision, corneal inlays, presbyLASIK, corneal shrinking techniques (conductive keratoplasty, laser thermal keratoplasty and intrastromal femtosecond laser-based procedures), multifocal IOLs [2]. The dynamic methods such as scleral implants and accommodative IOLs attempt to restore accommodation [2]. A corneal approach seems the safest, since it is the less invasive procedure.

Moreira et al. were the first ones to intentionally create a multifocal profile to correct myopia and maintain a good uncorrected near visual acuity (UNVA) by creating a central steeper area [3].

The term PresbyLASIK was introduced by Ruiz in 1996 [4]; it is a surgical technique based on the principles of LASIK to create a multifocal corneal surface.

There are 3 main types of multifocal corneal excimer laser profiles: 1) Multifocal transition profile, 2) Central PresbyLASIK, 3) Peripheral PresbyLASIK. The principles of each algorithm may be based on the dioptric power of refractive error and presbyopia correction calculation, corneal asphericity quotient (Q-value), higher-order spherical aberrations changes or optical and transition zone manipulation.


Multifocal transition profile

This technique had some popularity in the 1980s; it created a transitional vertical multifocal ablation based on the creation of an intentional decentration of a hyperopic ablation profile. Gobien et al. reported an improvement of 1 line of near UCVA in hyperopic presbyopes [5]. There are very few reports on this technique and it was not well accepted by surgeons because it induced significant levels of vertical coma [6].

Central PresbyLASIK

This technique was first described by Ruiz in 1996 where it creates a hyperpositive area for the near vision at the center, and the periphery is left for far vision (Fig. 1). It is pupil-dependent and an advantage is that it can be performed at the center of the cornea in myopic and hyperopic profiles, and in emmetropes with minimal corneal excision. Adequate centration is crucial for having a controllable result. Its main limitation is the lack of adequate alignment among the line of sight, the central pupil and the corneal vertex, inducing coma aberrations.

Fig. 1
figure 1

Differences between ablation patterns. In peripheral presbyLASIK, the center of the cornea is treated for distance vision and the periphery for near, while in central presbyLASIK, the center of the cornea is treated for near vision and the periphery for distance vision

Peripheral PresbyLASIK

In this technique, the center of the cornea is left for distance and the periphery is ablated in a way that a negative peripheral asphericity is created to increase the depth of the field (Fig. 1). However, when positive spherical aberration is present and if the pupil becomes miotic, the refraction of the eye experiences a shift towards positive spherical values that negatively influences near-vision performance [6].

One of its disadvantages is that when it is used in association with myopic correction, it is necessary to remove a significant amount of corneal tissue and therefore is mainly performed in hyperopes. It also requires an efficient excimer laser beam profile that can compensate the loss of energy that happens while ablating the peripheral cornea; this is one of the main difficulties in specifically targeting high negative asphericity values with this technique. A relatively flatter central cornea and more highly curved corneal mid-periphery was described by Avalos (PARM technique), and a proprietary peripheral presbyLASIK algorithm was described and patented by Tamayo.

Central PresbyLASIK technique

It is the most performed presbyLASIK technique [7], the first published results were reported by Alió et al. who reported a 6 months follow up in 25 hyperopes; 64% of the patients had an uncorrected distance visual acuity (UDVA) of 20/20, 72% of patients had a UNVA >20/40, and 28% of the patients had a loss of 2 lines of corrected distance visual acuity (CDVA). Coma aberrations increased and spherical aberrations decreased [8].

AMO Visx hyperopia-presbyopia multifocal approach

(AMO Development LLC, Milpitas, California) This design steepens the central zone to improve near vision and the peripheral zone for distance vision. It is for hyperopes patients with up to +4.0 D and -2.00 D of astigmatism [9].

Jackson et al. [10] reported a 12 month follow up using an aspheric presbyopia treatment, and wavefront guided hyperopic LASIK treatment using the VISX STAR S4 excimer laser (AMO). Fifty eyes completed the 12-month follow up, 100% had a binocular uncorrected distance vision of 20/25 or better, and an uncorrected near vision of J3. Ten percent of patients had a loss of >2 lines of CDVA. Higher order aberrations increased after surgery, mainly negative spherical aberration, which was correlated with the improved near visual acuity.


(Technolas Perfect Vision GmbH, Munich, Germany) is an aberration-optimized presbyopic algorithm. The Supracor creates a hyperpositive area in the central 3.0 mm zone (giving an addition of approximately 2 diopters [11]), the treatment targets 0.50 D of myopia in both eyes [12], being this the symmetrical technique, or it can be performed in an asymmetrical way, in which the target of the dominant eye is plano, and the non-dominant eye target is -0.50 D [4]. The asymmetrical technique is performed in patients that demand both near and distance vision, the symmetrical technique is for patients that demand good near vision [4]. It treats hyperopic presbyopia and minimizes the aberrations normally induced during treatment. This algorithm is available in the Teneo 317 and in the Technolas 217P excimer lasers [11] (Bausch and Lomb Technology, Munich Germany).

Ryan et al. reported the first results of the SUPRACOR technique. A binocular UDVA of 0.2 logMAR or better was achieved in 91% of the patients, also, 91% had an uncorrected reading ability of N8 or better, 6% lost 2 or more lines of CDVA, and 93% of the patients were fully independent of reading glasses. There was a small increase in higher order aberration (HOA) RMS, but no significant increase in coma or trefoil [12] .

A 1 year follow up by Schlote et al. [13] showed that 87.2% of the patients had an UNVA of >0.4 logMAR after Supracor, but 40% of the patients used reading glasses every day. Ten percent of the eyes lost 2 lines of CDVA.

Saib et al. reported a study using the SUPRACOR regular algorithm and a micro-monovision; 100% of the patients achieved a 20/25 distance vision and a 20/30 uncorrected near vision acuity 1 year after surgery. Eighty-four percent of patients achieved a simultaneous UDVA of 20/25 and UNVA of J1, 9.45% of patients lost one line of CDVA, and 4.05% lost 2 or 3 lines at 6 months. There was a more negative spherical aberration and vertical coma post operatively. Most of the patients (83.3%) were happy with their results [14].

Cosar et al. [15] performed a 6 months follow up, reporting an UNVA of 20/20 in 77.2% of eyes and 20/25 in 89.4% of the eyes, with a loss of 1 line in 28.5% of the eyes while 10.6% of the eyes lost 2 lines of CDVA.


PresbyMAX (SCHWIND eye-tech-solutions GmbH, Kleinostheim, Germany) is based on the creation of a biaspheric multifocal corneal surface with a central hyper positive area to achieve +0.75 to +2.50 D of near vision correction, surrounded by an area in which the ablation is calculated to correct the distance refractive error [16, 17].

Uthoff et al. used a Presbymax approach in hyperopic, myopic and emmetropic patients; 83% of all patients had an UDVA of 0.1 logMAR or better (made up of 100% of hyperopic, 80% of emmetropic and 70% of myopic patients). Ninety percent of the emmetropic, and 80% of hyperopic and myopic eyes had an uncorrected near visual acuity (UCNVA) of 0.3 logRAD or better. Ten percent of the hyperopic patients lost 2 lines of best corrected distance visual acuity (BCDVA), and 40% lost 1 line, and the same was with the emmetropic group, while for myopic patients: 10% lost 3 lines, 10% lost 2 lines, and 10% lost 1 line of BCDVA. There was a shift into negative spherical aberration and neither third order trefoil nor coma were significantly changed postoperatively. The most satisfied group was the hyperopic group. There was no retreatment, although this was only a 6 months follow up study [18].

Luger et al. reported using PresbyMAX treatment in myopes and hyperopes with or without astigmatism and published the outcomes of a year follow up. Seventy percent of patients had UDVA of 0.1 logMAR or better, 84% had UNVA of 0.1 logRAD or better, and 85% of patients had UDVA of 0.2 logMAR and UNVA of 0.2 logRAD or better. Three percent of the eyes lost 2 lines of CDVA and 8% of the eyes lost 2 lines of corrected near visual acuity (CNVA) [19].

Baudu et al. analyzed the uncorrected binocular results of PresbyMAX at 6 months in myopic and hyperopic presbyopic patients. 76% of patients had a binocular UDVA of 0.1 logMAR or better, 91% had an UNVA of 0.1 logRAD or better. Eighty percent of the patients achieved binocular success (determined as UDVA of 0.15 logMAR or better and UNVA of 0.15 logRAD or better [17].

Luger et al. reported the outcomes of PresbyMAX and micro-monovision, in both myopic and hyperopic presbyopes 1 year postoperatively. The dominant eye had a target refraction of -0.1 D, and the non-dominant eye (near eye) a target refraction of -0.9 D. Ninety-three percent of patients had an UDVA of 20/20, 90% with UNVA of J2, 97% with uncorrected intermediate visual acuity (UIVA) of J2, and 7% lost 2 Snellen lines of CDVA [16].

Chan et al. reported a follow up of 1 year of combining PresbyMAX in the non-dominant eye and contralateral monofocal distance correction in the dominant eye, in patients with bilateral hyperopia and presbyopia. Eighty-seven percent of the patients had UDVA 20/25 or better, and 83% had UNVA Jaeger level J2 or better. Simultaneous binocular near and distance vision of 20/25 and J2 or better was achieved in 70% of the patients. No patient suffered from a loss of 2 Snellen lines of CDVA, and 14% of the patients had a retreatment to improve near vision within 6 months to 1 year postoperative. There was a statistically significant induction of negative spherical aberration after the procedure, and the change in total HOA was significantly different between fellow eyes. Ninety-four percent of the patients were satisfied with their visual outcome, 26% of patients reported difficulty in visual performance in a low illuminated environment [20].

See Table 1 for a review on the results of central PresbyLASIK.

Table 1 Published outcomes for presbyopia correction with Central PresbyLASIK

Peripheral PresbyLASIK Technique

Peripheral Multifocal LASIK (PML) was described and developed by Pinelli; it creates a multifocal corneal profile in a 6.5 mm diameter zone. The distance correction is done at a 6 mm optical zone, and the near correction over a 6.5 mm optical zone; the ring between the 5 and 6.5-mm optical zone provides the multifocality [21]. It improves near vision by creating a prolate corneal shape with negative spherical aberration to increase depth of field [22].

Pinelli et al. reported the results using the PML technique in 44 hyperopic eyes, mean binocular UCVA was 1.06 ± 0.13 for distance and 0.84 ± 0.14 for near. 4.5% of the eyes lost 1 line of CDVA, and 45% of eyes gained 1 line of CDVA. They also reported a reduction in contrast sensitivity and a decrease in spherical and an increase in coma aberration [21].

Gordon reported a follow up of 3 months of 102 patients using the PML technique, and 81% of the patients had 20/20 UDVA, 44% had J1, 60% had J2, and 96% had a J3 UNVA. There was no loss of UDVA neither were there any visual complains [22] .

Epstein et al. investigated the outcomes of combination of monocular peripheral presbyLASIK on the non-dominant eye and monofocal distance vision correction on the dominant eye; the study included 103 patients (myopes and hyperopes) with a follow up of 1.1 to 3.9 years. 91.3% of all patients reported complete spectacle independence (89% hyperopes and 92% of myopes), UDVA was at least 20/20 in 67.9% of hyperopes and 70.7% of myopes. Seventy-one percent of hyperopes and 65.3% of myopes had a 20/20 vision at 40 cm; 14.3% of hyperopes lost one line of CDVA. There was no significant change in stereoacuity. Spherical aberration increased in the myopic group but decreased in the hyperopic group. All eyes that had PresbyLASIK had a statistically significant increase in total HOAs [23].

Danasoury et al. reported the outcomes of peripheral presbyLASIK in hyperopes and myopes with a follow up of 1 year. For the treatment of hyperopia and presbyopia a hyperopic ablation was performed with a 7.0 mm optical zone and a 9.5 mm transitional zone, the induced myopia due to the presbyopic correction was reversed centrally using two consecutive myopic ablations with optical zones of 3.5 and 4.0 mm with a transition zone that was 1.0 mm larger than the respective optical zones.

The treatment of the myopic group involved an ablation using 2 or 3 concentric optical zones at 4.0, 5.0, and 6.0 mm with a 2 mm transition zone that was larger than the optical zone. Presbyopia was treated with a hyperopic ablation with an optical zone of 7.00 and a 9.5 mm transition zone. The induced myopia was then reversed. Distance UCVA in the hyperopic group was 20/40 or better in 94% of the eyes, 20/25 in 83% and 20/20 or better in 56% of the eyes. In the myopic group, 44% of the eyes had UDVA of 20/20, 78% had 20/25 or better, and 90% had 20/40 or better.

Thirty-three percent of hyperopes had 20/40 or better UNVA and 36% of the myopes; even though myopes had a better UNVA than hyperopes, were least satisfied by the results (48% of myopes were satisfied vs. 54% of hyperopes). Two percent of eyes in each group lost two lines of CDVA. In the hyperopic group, there was a statistically significant change in ocular and corneal spherical aberration, but this was not observed in the myopic group [24].

See Table 2 for a review of peripheral PresbyLASIK results.

Table 2 Published outcomes for presbyopia correction with Peripheral PresbyLASIK

Laser Blended Vision (LBV, Carl Zeiss Meditec)

This technique induces a controlled spherical aberration (to increase depth of field [25], the induced negative spherical aberration goes from -0.50 to -0.70 μm) within a limited range to avoid degradation of the visual quality, with a small degree of monovision [26] to provide good near and distance vision. It can be performed on emmetropic, myopic and hyperopic presbyopes.

Reinstein et al. [25] reported the outcomes of LBV on emmetropic presbyopes; 96% had an UNVA of J2, the same outcomes were achieved for the treatment of myopic astigmatism and presbyopia [27]. In the case of hyperopic presbyopes, 81% of patients achieved a UNVA of J3 [28].

Yin et al. [7] used central presbyLASIK in the dominant eye and Q factor modulation (increase in negative Q factor for the improvement of depth of focus) in the non-dominant eye; the study included only hyperopes. The mean UNVA achieved was Jaeger 2, a mean UIVA and UDVA of 20/20. Regarding safety, 1 eye lost 2 lines and 5 eyes lost 1 line of CDVA one month after surgery, even though, 100% of the patients were satisfied with their results at 1 year after surgery.

Vastardis et al. [29] reported the outcomes of a multifocal aspheric corneal ablation, two groups were created, in one the target was emmetropia, and in the other group the target was a slight myopia (-0.5 D). In both groups, there was a significant improvement in UNVA, UIVA and UDVA and mini-monovision did not seem to affect the UDVA, UIVA and UNVA. A significant loss of lines of CDVA in both groups occurred.

A 6 months follow up was reported by Courtin et al. [30]. They used the Custom-Q nomogram (Alcon Laboratories, Inc., Fort Worth, TX), which allows the surgeon to select a target refraction and a target corneal asphericity. Only presbyopic hyperopes were included in the study. In the non-dominant eye, an aspheric ablation profile was planned, associated with a myopic refraction. A binocular UDVA of 20/20 was achieved in 91% of the patients, with 83% having a Jaeger 1 or better binocular UNVA.

See Table 3 for LBV results.

Table 3 Published outcomes for presbyopia correction with Laser Blended Vision


With this review, we can conclude that almost all authors reported a loss of at least 2 lines of distance visual acuity [8, 10, 11, 16, 18, 19, 21, 23, 24], which is a highly undesirable risk. The loss of vision can be secondary to dry eye or the induction of HOAs [11]. Patient selection seems crucial for having good results [11, 13]; the surgeon has to take into account patient expectations, their jobs and hobbies to see if they are good candidates for the procedure.

Most of the PresbyLASIK treatments have been performed in hyperopic patients [4, 7, 8, 1012, 14]. These patients are more satisfied with their outcomes than myopes [24], since the latter have always been used to having good near vision.

Different techniques of presbyLASIK are available (central, peripheral, blended vision) however, there is much more scientific evidence with the use of central presbyLASIK technique [7, 8, 1012, 14, 1619, 29] than with the use of peripheral presbyLASIK [2124]. Peripheral presbyLASIK removes an important amount of corneal tissue especially in the myopes, making this a limitation of the technique [6]. Central presbyLASIK can be performed in either myopes or hyperopes as the amount of tissue necessary for removal is minimal. Furthermore, the central model is more advisable to achieve multifocality due to the physiologic pupil miosis during accommodation [31].

One of the main limitations of PresbyLASIK is the lack of strong scientific evidence, and there are no reports of long term follow-ups, most of the papers have only a 6 to 12 months follow-up [7, 8, 10, 11, 2123, 29]. Spectacle independence varies from 72% [8] to 93% [12].

The combination of induced asphericity and micro-monovision with laser blended technique has had good visual and safety outcomes [25, 2730], but the tolerance to micro-monovision may be inconvenient especially in patients with mild presbyopia, who are less tolerant to a larger degree of anisometropia than patients with advanced presbyopia [25].

Presbyopia correction at the cornea can also be achieved with monovision, in which an intended anisometropia is induced, usually, the non-dominant eye is corrected for near vision, and the dominant eye for far vision, it depends on inter-ocular blur suppression. Good visual outcomes are achieved with this technique [32], but there is a loss of stereopsis which is related to the degree of anisometropia [33, 34], it is generally contraindicated in patients that need a good stereopsis to perform their daily activities such as airplane pilots [35, 36] or professional drivers [33, 36].

Corneal inlays are other way for the correction of presbyopia at a corneal level, depending on the inlay, they can either provide a multifocal effect by creating a hyper-prolate region of increased power in the cornea; improve the depth of focus, or they can act by altering the refractive index with a bifocal optic [37]. One of the advantages of corneal inlays over monovision or presbyLASIK is that there is no need of corneal tissue ablation, but, the patient must tolerate monovision and a loss of distance vision has been reported [3842].

Most of the procedures for presbyopic correction at a corneal level have the risk of losing lines of distance vision, but other procedures like the implantation of multifocal IOL in cataract surgery also carries risks like endophthalmitis, macular edema, suprachoroidal hemorrhage or retinal detachment [43].

Achieving a multifocal cornea with stable and long term results remains a challenge [7, 11, 13, 44] to all refractive surgeons. The combination of different techniques for the correction of presbyopia (monovision, multifocality, asphericity modification) is a trending option [30] seeing that they benefit from the best qualities of each procedure.



Corrected distance visual acuity


Corrected near visual acuity


Uncorrected distance visual acuity


Uncorrected intermediate visual acuity


Uncorrected near visual acuity.


  1. Frick KD, Joy SM, Wilson DA, Naidoo KS, Holden BA. The Global Burden of Potential Productivity Loss from Uncorrected Presbyopia. Ophthalmology. 2015;122(8):1706–10.

    Article  PubMed  Google Scholar 

  2. Charman WN. Developments in the correction of presbyopia II : surgical approaches. Ophthalmic Physiol Opt. 2014;34(4):397–426.

    Article  PubMed  Google Scholar 

  3. Moreira H, Garbus JJ, Fasano A, Lee M, Clapham TN, McDonnell PJ. Multifocal corneal topographic changes with excimer laser photorefractive keratectomy. Arch Ophthalmol. 1992;110:994–9.

    Article  CAS  PubMed  Google Scholar 

  4. Soler Tomás JR, Fuentes-Páez G, Burillo S. Symmetrical Versus Asymmetrical PresbyLASIK: Results After 18 Months and Patient Satisfaction. Cornea. 2015;34(6):651–7.

    Article  PubMed  Google Scholar 

  5. Gobin L, Trau R, Tassignon MJ. Treatment for combined hyperopia and presbyopia with a gaussian broad beam excimer laser. Bull Soc Belge Ophtalmol. 2008;307:27–36.

  6. Alió JL, Amparo F, Ortiz D, Moreno L. Corneal multifocality with excimer laser for presbyopia correction. Curr Opin Ophthalmol. 2009;20:264–71.

    Article  PubMed  Google Scholar 

  7. Wang Yin GH, McAlinden C, Pieri E, Giulardi C, Holweck G, Hoffart L. Surgical treatment of presbyopia with central presbyopic keratomileusis : One-year results. J Cataract Refract Surg. 2016;42:1415–23.

    Article  PubMed  Google Scholar 

  8. Alió JL, Chaubard JJ, Caliz A, Sala E, Patel S. Correction of presbyopia by technovision central multifocal LASIK (presbyLASIK). J Refract Surg. 2006;22(5):453–60.

    PubMed  Google Scholar 

  9. Tamayo GE. Multifocal cornea. In: Hampton Roy F, editors.Surgical techniques in ophthalmology: Refractive surgery. Philadelphia: Elsevier Saunders; 2008. 1st edition. p 127–143.

  10. Jackson WB, Tuan KM, Mintsioulis G. Aspheric wavefront-guided LASIK to treat hyperopic presbyopia: 12-month results with the VISX platform. J Refract Surg. 2011;27(7):519–29.

    Article  PubMed  Google Scholar 

  11. Ang RE, Cruz EM, Pisig AU, Solis ML, Reyes RM, Youssefi G. Safety and effectiveness of the SUPRACOR presbyopic LASIK algorithm on hyperopic patients. Eye Vis (Lond). 2016;3:33.

    Article  Google Scholar 

  12. Ryan A, O'Keefe M. Corneal approach to hyperopic presbyopia treatment : Six-month outcomes of a new multifocal excimer laser in situ keratomileusis procedure. J Cataract Refract Surg. 2013;39:1226–33.

    Article  PubMed  Google Scholar 

  13. Schlote T, Heuberger A. Multifocal corneal ablation (Supracor) in hyperopic presbyopia: 1-year results in a cross-sectional study. Eur J Ophthalmol. 2016 Dec 2:0. doi: 10.5301/ejo.5000871. [Epub ahead of print].

  14. Saib N, Abrieu-Lacaille M, Berguiga M, Rambaud C, Froussart-Maille F, Rigal-Sastourne JC. Central PresbyLASIK for Hyperopia and Presbyopia Using Micro-monovision With the Technolas 217P Platform and SUPRACOR Algorithm. J Refract Surg. 2015;31(8):540–6.

    Article  PubMed  Google Scholar 

  15. Cosar CB, Sener AB. Supracor hyperopia and presbyopia correction : 6-month results. Eur J Ophthalmol. 2014;24(3):325–9.

    Article  PubMed  Google Scholar 

  16. Luger MH, McAlinden C, Buckhurst PJ, Wolffsohn JS, Verma S, Arba Mosquera S. Presbyopic LASIK Using Hybrid Bi-Aspheric Micro-Monovision Ablation Profile for Presbyopic Corneal Treatments. Am J Ophthalmol. 2015;160(3):493–505.

  17. Baudu P, Penin F, Arba Mosquera S. Uncorrected Binocular Performance After Biaspheric Ablation Profile for Presbyopic Corneal Treatment Using AMARIS with the PresbyMAX Module. Am J Ophthalmol. 2013;155:636–47.

  18. Uthoff D, Pölzl M, Hepper D, Holland D. A new method of cornea modulation with excimer laser for simultaneous correction of presbyopia and ametropia. Graefes Arch Clin Exp Ophthalmol. 2012;250(11):1649–61.

    Article  PubMed  Google Scholar 

  19. 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.

    Article  PubMed  Google Scholar 

  20. Chan T, Kwok PS, Jhanji V, Woo V, Ng AL. Presbyopic Correction Using Monocular Bi-aspheric Ablation Profile (PresbyMAX) in Hyperopic Eyes: 1-Year Outcomes. J Refract Surg. 2017;33(1):37–43.

    Article  PubMed  Google Scholar 

  21. Pinelli R, Ortiz D, Simonetto A, Bacchi C, Sala E, Alió JL. Correction of Presbyopia in Hyperopia with a Center-distance, Paracentral-near Technique Using the Technolas 217z Platform. J Refract Surg. 2008;24:494–500.

    PubMed  Google Scholar 

  22. Gordon M. Presbyopia corrections with the WaveLight ALLEGRETTO: 3-month results. J Refract Surg. 2010;26:S824–6.

    Article  PubMed  Google Scholar 

  23. Epstein RL, Gurgos MA. Presbyopia treatment by monocular peripheral presbyLASIK. J Refract Surg. 2009;25:516–23.

    PubMed  Google Scholar 

  24. El Danasoury AM, Gamaly TO, Hantera M. Multizone LASIK with peripheral near zone for correction of presbyopia in myopic and hyperopic eyes: 1-year results. J Refract Surg. 2009;25:296–305.

    Article  PubMed  Google Scholar 

  25. Reinstein DZ, Carp GI, Archer TJ, Gobbe M. LASIK for Presbyopia Correction in Emmetropic Patients Using Aspheric Ablation Profiles and a Micro-monovision Protocol With the Carl Zeiss Meditec MEL 80 and VisuMax. J Refract Surg. 2012;28(8):531–41.

    Article  PubMed  Google Scholar 

  26. Gifford P, Kang P, Swarbrick H, Versace P. Changes to Corneal Aberrations and Vision After PresbyLASIK Refractive Surgery Using the MEL 80 Platform. J Refract Surg. 2014;30(9):598–603.

    Article  PubMed  Google Scholar 

  27. 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.

    Article  PubMed  Google Scholar 

  28. 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.

  29. Vastardis I, Pajic-Eggspühler B, Müller J, Cvejic Z, Pajic B. Femtosecond laser-assisted in situ keratomileusis multifocal ablation profile using a mini-monovision approach for presbyopic patients with hyperopia. Clin Ophthalmol. 2016;10:1245–56.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Courtin R, Saad A, Grise-Dulac A, Guilbert E, Gatinel D. Changes to Corneal Aberrations and Vision After Monovision in Patients With Hyperopia After Using a Customized Aspheric Ablation Profile to Increase Corneal Asphericity (Q-factor). J Refract Surg. 2016;32(11):734–41.

    Article  PubMed  Google Scholar 

  31. Alarcón A, Anera RG, Soler M, Del Barco LJ. Visual Evaluation of Different Multifocal Corneal Moldels for the Correction of Presbyopia by Laser Ablation. J Refract Surg. 2011;27(11):833–6.

    Article  PubMed  Google Scholar 

  32. Garcia-Gonzalez M, Teus MA, Hernandez-Verdejo JL. Visual Outcomes of LASIK-Induced Monovision in Myopic Patients With Presbyopia. Am J Ophthalmol. 2010;150:381–6.

    Article  PubMed  Google Scholar 

  33. Hayashi K, Ogawa S, Manabe S, Yoshimura K. Binocular Visual Function of Modified Pseudophakic Monovision. Am J Ophthalmol. 2015;159(2):232–40.

    Article  PubMed  Google Scholar 

  34. Greenstein S, Pineda R 2nd. The Quest for Spectacle Independence : A Comparison of Multifocal Intraocular Lens Implants and Pseudophakic Monovision for Patients with Presbyopia. Semin Ophthalmol. 2017;32(1):111–5.

  35. Zhang F, Sugar A, Arbisser L, Jacobsen G, Artico J. Crossed versus conventional pseudophakic monovision : Patient satisfaction, visual function, and spectacle independence. J Cataract Refract Surg. 2015;41:1845–54.

    Article  PubMed  Google Scholar 

  36. Goldberg DB. Laser in situ keratomileusis monovision. J Cataract Refract Surg. 2001;27:1449–55.

    Article  CAS  PubMed  Google Scholar 

  37. Lindstrom RL, Macrae SM, Pepose JS, Hoopes PC Sr. Corneal inlays for presbyopia correction. Curr Opin Ophthalmol. 2013;24:281–7.

  38. Seyeddain O, Hohensinn M, Riha W, Nix G, Rückl T, Grabner G, et al. Small-aperture corneal inlay for the correction of presbyopia : 3-year follow-up. J Cataract Refract Surg. 2012;38:35–45.

    Article  PubMed  Google Scholar 

  39. Igras E, O'Caoimh R, O'Brien P, Power W. Long-term Results of Combined LASIK and Monocular Small-Aperture Corneal Inlay Implantation. J Refract Surg. 2016;32(6):379–84.

    Article  PubMed  Google Scholar 

  40. Baily C, Kohnen T, O'Keefe M. Preloaded refractive-addition corneal inlay to compensate for presbyopia implanted using a femtosecond laser : One-year visual outcomes and safety. J Cataract Refract Surg. 2014;40:1341–8.

    Article  PubMed  Google Scholar 

  41. Limnopoulou AN, Bouzoukis DI, Kymionis GD, Panagopoulou SI, Plainis S, Pallikaris AI, et al. Visual Outcomes and Safety of a Refractive Corneal Inlay for Presbyopia Using Femtosecond Laser. J Refract Surg. 2013;29(1):12–8.

    Article  PubMed  Google Scholar 

  42. Whitman J, Dougherty PJ, Parkhurst GD, Olkowski J, Slade SG, Hovanesian J, et al. Treatment of Presbyopia in Emmetropes Using a Shape-Changing Corneal Inlay: One-Year Clinical Outcomes. Ophthalmol. 2016;123:466–75.

    Article  Google Scholar 

  43. Chan E, Mahroo OA, Spalton DJ. Complications of cataract surgery. Clin Exp Optom. 2010;93(6):379–89.

    Article  PubMed  Google Scholar 

  44. Oh DH, Chun YS, Moon NJ, Kim JC. Efficacy of aspheric corneal ablation with the central-saving technique for presbyopic correction through early wound healing modulation. Cornea. 2013;32(1):30–5.

    Article  PubMed  Google Scholar 

Download references


Not applicable.

Availability of data and materials

Not applicable.

Authors' contributions

VVF is the main author, and JLA revised and supervised the paper. Both authors read and approved the final manuscript.

Competing interests

VVF has no competing interests. JLA has a competing interest; PresbyMAX is JLA trademark.

Consent for publication

Not applicable.

Ethics approval and consent to participate

Not applicable.

Author information

Authors and Affiliations


Corresponding authors

Correspondence to Veronica Vargas-Fragoso or Jorge L. Alió.

Rights and permissions

Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Vargas-Fragoso, V., Alió, J.L. Corneal compensation of presbyopia: PresbyLASIK: an updated review. Eye and Vis 4, 11 (2017).

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: