It is estimated that presbyopia affects more than 120 million Americans; unfortunately, like death and taxes, presbyopia is something that no one can avoid.

Despite its prevalence, presbyopia is often viewed as a trivial disease with over-the-counter reading glasses serving as an inexpensive and convenient treatment option. However, there is a demand for a better alternative, and, if given the choice, I think patients would rather do away with their reading glasses.

BEYOND READING GLASSES

Currently available treatment options include presbyopia-correcting IOLs (PC-IOLs), which have been available for years. Despite improvements in IOL technology and potentially higher reimbursement, adoption of presbyopia-correcting IOLs has been fairly stagnant.

In addition, the first eyedrop for the treatment of presbyopia was approved by the FDA in late 2021. As practitioners, we are still learning how to educate and counsel our patients on this new class of therapeutics.

A PROMISING FUTURE AHEAD

The future of presbyopia treatment is exciting, with a rich pipeline of both medical and surgical options. Several presbyopia drops are in various stages of FDA approval. Although not currently available in the United States, Presbyond excimer laser blended vision treatments have shown promising results in Europe. By utilizing aspheric ablation profiles to increase depth of field in combination with a small amount of anisometropia, patients have the potential to achieve a full range of vision while limiting some of the downsides of traditional monovision. Lastly, I am especially excited about the new IOL technologies that may be available in the near future, especially the elusive truly accommodating IOL.

IN THIS ISSUE

I am both excited and honored to be the guest editor of this presbyopia issue of Ophthalmology Management, where we will cover both current and future treatments on this hot topic.

Dr. Dagny Zhu and Shambhawi Thakur provide best practices for prescribing presbyopia eyedrops, including careful patient selection and counseling. They also give an overview of the presbyopia-correcting drops expected to be available in the near future.

Regarding PC-IOLs, several key opinion leaders share their secrets to success to helping patients choose these premium lenses. Strategies discussed included patient education, under-promising and over-delivering, as well as how to discuss financing. Dr. Sumitra S. Khandelwal and William Xu explain how to ensure patient satisfaction and optimize visual outcomes with PC-IOLs. In addition, contributing editor Conni Koury highlights the PC-IOLs coming down the pipeline that we may soon have at our disposal.

I want to thank all the authors for contributing their expertise and I hope you enjoy reading this issue as much as I did. OM

Beeran Meghpara, MD, is the co-director of refractive surgery at Wills Eye Hospital in Philadelphia. He was named to Ophthalmology Management’s 40 Under 40 list in 2022. Disclosures: Dr. Meghpara reported relationships with BioTissue, Centricity, Dompe, Glaukos, Kala, Oculus, Santen, Sight Sciences, Sun, Tarsus, Thea and WL Gore & Associates.