A system and process for correcting presbyopia with the system including a
tissue removal system that preferably includes a laser system with means
for forming a predetermined presbyopia correction contour corresponding to
a predetermined ablation profile through controlled ablation of an exposed
corneal stroma area of the eye such that a central zone of about 1-3 mm
or, more preferably, 1.4 to 1.8 mm is left intact with a main, maximum
presbyopia ablation zone bordering the untouched or hardly touched (e.g.,
a radiused transition edge) central zone. The annular maximum ablation
zone in the stroma is defined by a smoothly curving, steep profile section
which extends out from a central, non-ablation section of the profile.
Further outward from the maximum ablation zone in the stroma is an annular
treatment zone that is determined by a further section of the presbyopia
correcting profile generally represented by a smoothing transition section
that extends into another zone which is an unablated zone. The method and
device for controlling the formation of the desired corneal stroma
configuration preferably involves a presbyopic corrective module based on
a predetermined profile determining equation that utilizes certain inputs
which preferably include values determined by eye measurements and,
preferably, also values pulled from a plurality of zone diameter ranges
and a range for maximum depth. The manner in which this profile
controlling information is implemented in the ablation or tissue removal
process is preferably provided by modification of a present control system
of one or more preexisting laser systems such as those used in hyperopia
and myopia correction procedures. This modification can include, for
example, an added software or hardware module, the formation of a mask
with or without a mask movement assembly, or the formation of a suitable
mold or shaping device for forming, for example, an erodible mask that can
input the desired contour to the exposed corneal stroma. The system and
apparatus of the present invention also preferably involve a microkeratome
or the like for forming resections in the eye to expose the corneal
stroma. A positioning marker, cleaning system and drying system are also
preferably used in the present invention to facilitate, for example,
corneal flap formation, laser positioning, flap repositioning on a clean
surface following ablation and providing a dry corneal stroma surface to
the ablating laser. With the system and method of the present invention
there is provided a way to efficiently and safely correct problems
associated with presbyopia while retaining good near and far vision
capabilities and with reduced undesirable post-operative symptoms.