Introduction

Imagine sitting at your favorite café in Gangnam, only to realize you’re holding your phone farther and farther away just to read a text. Or picture yourself struggling to swap between reading glasses and distance glasses in the middle of a busy workday. If you’re over 45, chances are these small frustrations aren’t unfamiliar. This is presbyopia — the gradual loss of near focusing ability that comes with age.

At GS Eye Center in Seoul, we meet countless patients in their 40s, 50s, and beyond who ask the same question: “Doctor, which surgery is really best for presbyopia?” The answer depends on your lifestyle, your eye health, and the technologies available. Let’s walk through the options with the clarity you deserve.

Understanding Presbyopia: Why It Happens After 45

Presbyopia isn’t a disease — it’s a natural aging process. The lens inside your eye, once flexible like a camera’s zoom function, becomes stiffer over time. By your mid-40s, reading menus, checking messages, or working at a computer becomes noticeably harder.

This process happens to everyone, regardless of whether you’ve had perfect eyesight before. Even patients who had LASIK in their 20s or 30s eventually experience presbyopia, because the lens itself continues to age.

In South Korea, where digital device use is among the highest in the world, the impact of presbyopia is especially noticeable. Professionals in their 40s often juggle smartphones, laptops, and meetings. Constantly switching between reading glasses and distance correction isn’t just inconvenient — it can feel like a barrier to productivity and confidence.

That’s why more and more patients seek surgical solutions: to reclaim seamless vision without depending on multiple pairs of glasses.

The Main Surgical Options for Presbyopia

There isn’t a single “one-size-fits-all” surgery. The right procedure depends on whether cataracts are present, how much flexibility you want for near and distance vision, and even how your brain adapts to new visual inputs.

Let’s review the most important options available today.

1. Lens Implant Surgery (Multifocal or EDOF IOLs)

Lens replacement surgery has become the gold standard for patients over 45, particularly those who are starting to develop early cataracts. This procedure replaces the natural aging lens with an artificial intraocular lens (IOL) that restores focusing ability.

• Multifocal IOLs split light into two or more focal ranges, giving patients near and far vision without glasses.

• EDOF (Extended Depth of Focus) IOLs provide a continuous range of focus, especially strong for intermediate vision, such as computer use.

For many patients, this is like replacing a foggy, outdated camera lens with a high-resolution one that works in all conditions. Not only does it address presbyopia, but it also eliminates the risk of needing cataract surgery later on.

At GS Eye Center, lens implant surgery is particularly recommended for:

• Patients in their late 40s to 60s

• Individuals noticing both presbyopia and early cataract symptoms (glare at night, cloudy vision, reduced contrast)

• Patients seeking a long-term solution that won’t need to be repeated

Clinical note: Unlike LASIK or SMILE, lens replacement doesn’t depend on corneal thickness. This makes it an option for patients who may not qualify for laser surgery due to thin or irregular corneas.

2. Laser Vision Correction for Presbyopia (Monovision SMILE Pro or LASIK)

For younger presbyopia patients — especially those in their early 40s — advanced laser techniques can provide freedom from reading glasses. The most common approach is monovision correction, where one eye is adjusted for near vision and the other for distance.

• SMILE Pro (Small Incision Lenticule Extraction) is currently the most advanced laser option. Using a tiny, 2 mm incision, a small piece of corneal tissue (lenticule) is removed to reshape the cornea. Compared to LASIK, SMILE Pro causes less dryness, preserves more corneal strength, and heals faster.

• Monovision LASIK is another option, but recovery is typically slower and dry eye risk is higher than with SMILE Pro.

The idea of monovision may sound unusual — one eye for near, one for far — but most brains adapt surprisingly well. Many patients report that within days, the adjustment feels natural. Busy professionals often choose SMILE Pro because it allows them to continue daily life almost immediately, with minimal discomfort.

Clinical insight: Not everyone tolerates monovision equally well. That’s why GS Eye Center performs a monovision “trial” using contact lenses before surgery, allowing patients to experience how their brain adapts before making a permanent decision.

3. Corneal Inlays

Corneal inlays — small implants inserted into the cornea — were once marketed as a minimally invasive way to correct presbyopia. However, long-term studies revealed higher complication rates, such as glare, halos, and reduced clarity, often requiring removal.

Because of these drawbacks, corneal inlays are now rarely recommended worldwide, including in Korea. At GS Eye Center, we focus on safer and more predictable options like SMILE Pro or lens replacement.

Which Is the “Best” Choice After 45?

Patients often ask: “Just tell me the single best option.” But the truth is, the best procedure depends on your age, lifestyle, and whether cataracts are present.

• If you don’t yet have cataracts (early-to-mid 40s): Monovision SMILE Pro offers a minimally invasive way to enjoy freedom from glasses while keeping your natural lens intact.

• If you’re already developing cataracts (late 40s to 50s+): Multifocal or EDOF lens implants provide the most definitive, long-term solution.

Think of it this way:

• SMILE Pro is like fine-tuning your existing camera lens.

• Lens replacement is like installing a brand-new lens system, designed to last for life.

At GS Eye Center, we guide patients through this decision by performing detailed diagnostic testing and explaining the long-term implications of each choice.

What Patients Often Overlook

When researching presbyopia surgery, most people focus on the “headline” technologies: SMILE Pro, multifocal lenses, LASIK. But what truly determines success is the diagnostic process and the surgeon’s experience.

At GS Eye Center, every presbyopia evaluation includes:

• Corneal shape and thickness mapping to ensure safety for laser procedures

• Tear film analysis to minimize dry eye risk

• Retinal imaging to rule out underlying macular conditions

• Lens opacity testing to detect early cataracts

These tests help determine not only whether a surgery is possible, but which surgery will deliver the clearest and most comfortable vision.

To be honest, most patients are surprised by how quick recovery can be. With SMILE Pro, many return to work the very next day. With lens implant surgery, patients often report immediate clarity — like a curtain lifting — and resume daily activities within a few days.

Choosing the Right Clinic in Seoul

In Korea, patients are fortunate to have access to some of the world’s most advanced eye surgery technologies. But choosing the right clinic is just as important as choosing the right procedure.

Here’s what to look for:

• Experience across both laser and lens-based options. Clinics that only offer one type may steer patients toward it, even if another procedure is a better fit.

• Advanced diagnostic equipment. Accurate measurements are the foundation of safe, successful outcomes.

• A team of board-certified ophthalmologists. Academic training and surgical experience matter when dealing with delicate eye structures.

GS Eye Center, founded in 2005 in Gangnam, represents this integrated approach. Under the leadership of Dr. Kim Moo-Yeon, a former professor and internationally recognized ophthalmologist, our center combines 20+ years of experience with the latest diagnostic and surgical technologies. Our team of seven board-certified specialists ensures that every patient receives personalized, detail-oriented care.

Final Thoughts: Regaining Clear Vision After 45

Presbyopia is inevitable, but struggling with glasses or blurred near vision doesn’t have to be. Whether through monovision SMILE Pro in your early 40s or multifocal lens implants in your 50s, there are proven solutions that restore both clarity and confidence.

The key is not just choosing the most advanced technology, but choosing the right treatment for your eyes and lifestyle. At a trusted center like GS Eye Center in Gangnam, you’ll find not only the latest surgical options but also a patient-first approach that makes the journey safe and reassuring.

If you’ve been noticing that reading or multitasking is becoming more difficult, it may be time to consider a presbyopia evaluation.