Surgical interventions for presbyopia.

Area of Science:

• Ophthalmology
• Vision Science
• Surgical Interventions

Background:

• Presbyopia is an age-related condition causing near and intermediate vision impairment.
• Surgical options for presbyopia are emerging, but their effectiveness and safety require systematic evaluation.
• Understanding surgical outcomes is crucial for patient decision-making and resource allocation.

Purpose of the Study:

• To compare the effectiveness and safety of various surgical interventions for presbyopia.
• To provide an economic commentary on surgical interventions for presbyopia.

Main Methods:

• Systematic review of randomized controlled trials (RCTs) comparing surgical interventions for presbyopia.
• Searched multiple databases and trial registries up to February 2024.
• Assessed risk of bias using Cochrane RoB 2 tool and certainty of evidence with GRADE.

Main Results:

• Included four RCTs with 300 participants; data were limited to short-term outcomes (3-6 months) with low to very low certainty evidence.
• No significant differences were found between diffractive bifocal IOLs and refractive bifocal IOLs for spectacle independence or satisfaction.
• LASIK monovision showed potential for improved intermediate vision spectacle independence and reduced ocular adverse events compared to diffractive bifocal IOLs.

Conclusions:

• Current evidence on surgical interventions for presbyopia is limited by short-term follow-up and low-certainty data.
• Further high-quality research is needed to establish the long-term effectiveness and safety of these procedures.
• Economic evaluations of surgical interventions for presbyopia are lacking.