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Refractive surgery · London

PRESBYOND Laser Blended Vision, by a Zeiss-trained surgeon.

A same-day laser treatment for presbyopia on the Zeiss VisuMax and MEL 90 platforms, using the Reinstein blend-zone protocol so both eyes keep working at every distance. Home the same afternoon, driving the next day.

A stethoscope on a clinical desk

Indicative pricing

What private PRESBYOND costs in the UK.

Indicative ranges across UK private providers.

In short

PRESBYOND for both eyes in London: £5,500 to £8,500, including 12 months of aftercare.

Procedure Indicative range
Full PRESBYOND workup and contact-lens simulation £350–£600
PRESBYOND Laser Blended Vision, both eyes £5,500–£8,500
PRESBYOND with premium 12-month aftercare package £6,800–£8,500
Enhancement top-up within 12 months Included
Refractive lens exchange with EDOF or trifocal IOL £6,500–£10,500
Second-opinion review of another clinic’s plan £250–£450

Prices vary by surgeon, by clinic, by whether a premium 12-month aftercare bundle is included, and by the complexity of your prescription.

When it helps

When PRESBYOND is the right step, and when it is not.

The prescriptions and life patterns PRESBYOND suits, plus the corneal and lens findings that push us toward a lens-based option instead.

  • Presbyopia between 45 and 70

    The core PRESBYOND indication: reading vision that has drifted over the last few years, with or without a low background prescription.

  • Low hyperopia with presbyopia

    Mild long-sight that has started to bite in your forties, when distance was fine but near has gone. PRESBYOND covers both in a single treatment.

  • Low myopia losing the reading trick

    Short-sighted patients who used to take their glasses off to read, and whose near workaround is failing as the eye stiffens with age.

  • Mild residual astigmatism

    Up to about 1.5 dioptres of regular astigmatism is corrected in the same ablation on the MEL 90 platform.

  • Failed traditional monovision contact trial

    Some patients cannot tolerate classical monovision because of the mid-range gap. PRESBYOND’s blend zone often works where monovision did not.

  • Not for keratoconus or thin corneas

    Any suspicion on Pentacam or epithelial mapping and PRESBYOND is off the table. We would consider ICL or a lens-based option instead.

  • Not for early or established cataract

    If the lens is already cloudy, refractive lens exchange with an EDOF or trifocal IOL treats the cataract and presbyopia in one operation.

  • Red flag: severe dry eye

    Uncontrolled dry eye disease worsens after any LASIK-based procedure. Tear-film treatment first, then reassess.

Procedure options

PRESBYOND sits inside a family of presbyopia solutions.

What each option actually involves, and which fits which eye. For higher hyperopia, thin corneas or early cataract, we usually move to a lens-based route.

  • PRESBYOND Laser Blended Vision (Zeiss)

    The Reinstein protocol on VisuMax femtosecond plus MEL 90 excimer. Dominant eye set for distance with slight micro-monovision, non-dominant eye set for near, controlled spherical aberration creates the blend zone.

  • How PRESBYOND differs from monovision

    Traditional monovision leaves a blind mid-range and forces one eye to switch off. PRESBYOND uses induced spherical aberration to extend the depth of focus so both eyes contribute at every distance.

  • SMILE with micro-monovision

    A flap-free VisuMax alternative for younger presbyopic myopes, using a mild monovision offset without the true blend-zone algorithm of PRESBYOND.

  • Refractive lens exchange with EDOF IOL

    Symfony or Vivity extended depth-of-focus lenses swap the natural lens. Best fit for higher hyperopia, early cataract, or those over 55 with a stiff lens.

  • Refractive lens exchange with trifocal IOL

    PanOptix or Synergy trifocals give distance, intermediate and near from a single lens. More glasses independence, more risk of halos and dysphotopsia than EDOF.

  • Toric IOL for astigmatism

    When the corneal astigmatism is too high for laser correction alone, a toric platform on top of the EDOF or trifocal handles it inside the eye.

  • ICL implantable contact lens

    For thin corneas or very high prescriptions where laser is unsafe. Not a presbyopia treatment on its own, but can be combined with a later reading solution.

  • Second-opinion review

    A specialist review of another clinic’s scans, biometry and plan. Sometimes the answer is a different technology, or waiting until cataract develops.

Safety and recovery

What to expect afterwards, honestly.

PRESBYOND is a well-established LASIK-based refractive procedure. The things worth planning are the adaptation window, dry-eye care, and the low chance of an enhancement top-up in the first year.

  • The blend-zone adaptation window

    Most patients see the blended vision working within days, but full neural adaptation can take 6 to 12 weeks. Reading in low light is the last thing to settle.

  • Dry eye for the first few months

    Any LASIK-based treatment reduces corneal nerve sensation for a while. Preservative-free lubricants for 3 to 6 months is standard.

  • Night vision and halos

    A halo around bright lights at night is common in the first weeks and usually resolves. Very rarely it persists and is discussed on consent.

  • Enhancement rate is low

    Around 5 to 8 per cent of PRESBYOND patients have a small refinement treatment within the first year, included in the package price.

  • Reading glasses for very fine print

    PRESBYOND aims for functional reading without glasses at menus, phones and books. A pair of low-strength readers may still help with very small print in dim light.

  • Not a cure for cataract

    PRESBYOND treats the cornea, not the lens. If cataract develops years later you will still need cataract surgery and can choose an IOL that keeps the near effect.

  • Sports and screens

    Non-contact sport at 1 week, contact sport and swimming at 4 weeks. Screens are fine from the next day within comfort.

  • Driving and DVLA standards

    Around 98 per cent of PRESBYOND patients meet the DVLA distance standard unaided. A next-day check confirms whether you can drive.

  • Red flags after treatment

    Sudden vision loss, severe pain, worsening light sensitivity or a shadow across vision needs same-day contact with the clinic or A&E.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Refractive surgery for presbyopia is usually self-funded rather than covered by private medical insurance.

Frequently asked

Everything we get asked about PRESBYOND.

Quick answers on how the blend zone works, cost, candidacy, and how it compares to lens-based options.

  • What is PRESBYOND Laser Blended Vision?

    PRESBYOND is a Zeiss laser treatment for presbyopia using the VisuMax femtosecond and MEL 90 excimer platforms. The dominant eye is set for distance with a small amount of micro-monovision, the non-dominant eye is set for near, and a controlled amount of spherical aberration is induced so both eyes still contribute across intermediate distances. The brain fuses the two images into a single continuous range of focus.

  • How is PRESBYOND different from traditional monovision?

    Traditional monovision fully corrects one eye for distance and the other for near, leaving a blind gap at intermediate distances and forcing the brain to suppress one eye. PRESBYOND extends the depth of focus in each eye through induced spherical aberration, so the two eyes overlap in a blend zone and both continue to work at every distance. Tolerance rates are far higher and the mid-range is filled in.

  • What outcomes are realistic?

    Published data from the London Vision Clinic and independent centres shows around 97 per cent patient satisfaction, with 95 per cent or more reading J2 near print unaided and around 98 per cent meeting the DVLA distance standard without glasses. A small proportion still use low-strength reading glasses for very fine print in dim light.

  • Who is a candidate?

    Adults roughly 45 to 70 with presbyopia, healthy corneas on Pentacam and epithelial mapping, stable prescription, controlled tear film, and no early cataract. Suitable prescriptions range from low myopia to moderate hyperopia with up to about 1.5 dioptres of astigmatism. The contact-lens simulation trial is crucial: if your brain does not tolerate the blend, you should not have the treatment.

  • How much does PRESBYOND cost in the UK?

    A private PRESBYOND treatment for both eyes runs £5,500 to £8,500 including 12 months of aftercare and any enhancement top-up in that period. A full workup with the contact-lens simulation is £350 to £600. Refractive lens exchange with an EDOF or trifocal IOL is £6,500 to £10,500.

  • Where is PRESBYOND done in London?

    The London Vision Clinic on Harley Street is where Professor Dan Reinstein originated the PRESBYOND protocol. Other reputable London providers include Optegra, Advanced Vision Care, OCL Vision, Focus Clinics and Moorfields Private Refractive.

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