Eye drops instead of glasses? Drops for presbyopia vs. PresbyLASIK, Allotex TransForm™ and lens replacement – a comparison of methods

We’ve all been there: you’re standing in the store, trying to read the ingredients on a yogurt pot and the letters blur before your eyes. You hold the product further and further away from your face until you stretch your arm out like a giraffe stretching its neck to grab leaves from a tall tree. This is presbyopia – the presbyopia that sooner or later knocks on the door of every one of us after the age of forty.

The right solutions? These are mainly surgical procedures: PresbyLASIK, Allotex TransForm™ and lens replacement, which we have mastered perfectly at the EyeLaser Clinic. But there is now also an interesting alternative – the VIZZ (aceclidine) and Vuity (pilocarpine) drops. The FDA has just given the green light for VIZZ and the manufacturer promises that they will be on the market in America this year.

The question is: Are the drops a real revolution or rather a plaster on a deeper wound? Dr. Victor Derhartunian, who has treated hundreds of patients suffering from presbyopia in his career, explains why surgery will remain the way to go in this area.

What exciting insights are there?

• Will the new VIZZ drops really revolutionize the eyewear market? The effect only lasts a few hours, so it’s more of a temporary patch than a real solution.
• Which methods provide a permanent cure for presbyopia? PresbyLASIK, Allotex TransForm™ and lens replacement are proven techniques that provide a lasting solution to the problem.
• Why does surgery beat drops in the long run? Once done, it lasts for years – plus it comprehensively corrects vision and saves money in the long term.
• How do you choose the best method for you? It depends on your lifestyle, the degree of presbyopia and other visual defects – at EyeLaser Vienna we fit the treatment like a tailor-made suit.
• Are the latest technologies available to Austrian patients? In our clinic we have a wide range of the most modern methods for vision correction.

How do drops work against presbyopia?

The mechanism? The drops constrict the pupil (in medicine we say “miosis”), which creates a pinhole effect. It’s like looking through a keyhole – everything nearby appears sharper because the depth of field increases.

VIZZ (Aceclidine)

• Precisely targets the pupillary sphincter and bypasses the ciliary muscle
• Does not impair vision in the distance (a great advantage!)
• Works for up to 10 hours – no need to carry a pipette in your pocket
• Packed in sterile disposable ampoules
• Reversible – can be used again every day.

Vuity (Pilocarpine)

• Attacks both muscles simultaneously – the pupillary sphincter and the ciliary muscle
• May cause temporary short-sightedness and dizziness
• Lasts about 6 hours – shorter duration of action than VIZZ
• Reversible – can be used again every day.

VIZZ studies

VIZZ underwent a series of clinical trials with 466 volunteers. The CLARITY studies showed that:

• The effect sets in after just half an hour
• It lasts for 10 hours
• The correction can be repeated from day to day

Most patients reported mild side effects. Most common: mild irritation, blurred vision and occasional headaches.

Advantages and disadvantages of the drops

Convincing advantages:

• Lightning-fast start – the effect is quickly noticeable
• No scalpel – no pre- and post-operative stress
• You can always stop by no longer taking them

Restrictions:

• The effect only lasts for hours and they must be taken daily
• Side effects can be annoying – blurred vision at night, sometimes headaches
• Only presbyopia is corrected, other visual defects remain unaffected
• Presbyopia progresses anyway – drops are a symptom relief, not a solution to the problem
• Costs – annually it can cost as much as a nice vacation

Modern surgical methods – the right solutions for presbyopia

Now it’s getting exciting! Unlike drops, which are like renting an apartment, surgery is like buying your own home. At EyeLaser Vienna, we are experts in the most modern methods of vision correction.

1. presbyLASIK – multifocal vision profile with the laser

How does it work? The laser precisely reshapes the cornea and creates a multifocal vision profile.

Advantages that give pleasure:

• Once made, it corrects for decades – a long-term investment
• “All inclusive” package – presbyopia plus correction of other visual defects in one go
• Quick return to everyday life – you are normally back in action the next day
• Proven technology – thousands of satisfied patients worldwide
• Economically viable – you pay once, don’t buy more every month

Disadvantages? Few:

• The cornea must be in good condition and sufficiently thick
• The brain needs time to adapt (2-6 months)
• Temporary dryness of the eyes in some patients

2 Allotex TransForm™ – the bio-lens from the future

How does Allotex TransForm™ work? The implantation of an ultra-thin bio-lens made of human cornea into your cornea. Sounds futuristic? It is!

Strengths:

• Reversible – can be removed if required
• 100% natural material – your body accepts it well
• The anatomy remains untouched – no radical changes
• One-eye strategy – it is often enough to correct just one eye

At the EyeLaser Clinic, we are experts in this innovative method!

Weak points:

• Long-term effects – we are still collecting data
• Adjustment phase – can be uncomfortable at first
• Theoretical risk of rejection – the body can react to the artificial lens with rejection, although this is rare

3. lens exchange (RLE) – the method for best results

The idea: We remove the natural lens and insert a multifocal or EDOF (Extended Depth of Focus) lens.

Unbeatable advantages:

• Permanent solution – the effect lasts a lifetime
• Universal key – corrects absolutely all visual defects
• Cataracts? Not for you – the artificial lens never gets cloudy
• Ideal for high visual defects – where the laser reaches its limits
• Wide selection and individual adjustment – different lens types for different needs

Disadvantages:

• Greater invasiveness – we correct the substance of the eye
• Possible halos at night – depends on the lens type
• Longer recovery phase – several weeks until full recovery
• Higher costs – quality has its price

Comparison table of the methods

Method	Duration of the effect	Correction range	Recovery time / recuperation time	Invasiveness	Main side effects
Drops (VIZZ/Vuity)	Hours	Presbyopia only	None	Non-invasive	Blurred vision at night, headaches
PresbyLASIK	years	Presbyopia + other visual defects	Few days	Minimal	Dry eyes, temporary glare effects
Allotex TransForm™	Years (reversible)	Presbyopia	A few days – weeks	Minimal	Discomfort, theoretical risk of rejection
Lens replacement	Permanent	All visual defects	Weeks	Moderate	Halos, nocturnal glare effects

Are eye drops for presbyopia really the cheaper solution?

Let’s turn this into an everyday example: do we prefer to pay for an expensive rental car or buy a car for the rest of our lives?

Drops are recurring costs without end:

• Annual: approx. 800-1200 USD
• In 10 years: 8000-12000 USD
• In 20 years: 16000-24000 USD (the price of a new car!)

Surgery is the purchase of property:

• One-off: 3000-8000 USD
• Other costs? Zero (in connection with presbyopia)
• The economic efficiency in comparison is clear.

When should you choose drops and when should you go under the knife?

Drops fit when:

• you would like to try out the correction before making a decision
• you have contraindications for an operation
• Presbyopia is your only visual problem
• you like unlimited reversibility – from day to day
• you need occasional, not daily correction

Surgery is unbeatable when:

• you are looking for a permanent, precise solution
• you also have to correct visual defects other than presbyopia
• You appreciate independence from glasses, contact lenses and drops
• Presbyopia already severely limited
• Your lifestyle requires functioning vision throughout the day

Dr. Derhartunian shares his experiences

At Eyelaser, we are watching the future of ophthalmology from the front row.
“Drops are an interesting option,” says Dr. Derhartunian, “But after 20 years in practice, I know that patients want peace and quiet above all else. They want to wake up in the morning and see clearly without thinking about drops, glasses or the fear that the effect will wear off straight away.”

Dr. Derhartunian, who also runs the EyeLaser clinics in Vienna and the Laser Surgery Center in Zurich, adds: “I recently operated on a patient who had been using drops for presbyopia for six months. He told me: ‘Doctor, this is like dating someone who will never commit. I want marriage with good eyesight now!'”

In short…

Drops against presbyopia? A cool invention, no question. But it’s like a battery-powered flashlight in the age of LEDs – it may work when you need it, but in the long run you’re almost always hoping for more than it can deliver.

The real solutions are PresbyLASIK, Allotex TransForm™ and lens replacement. They give a lasting effect, save money and restore true visual freedom. At Eyelaser, we know these methods like the back of our hand and adapt them individually to each patient.

Our experience from thousands of procedures performed? Patients who have opted for surgery say one thing: “Too bad I didn’t do it sooner!”

Frequently asked questions (FAQ)

Can VIZZ drops already be bought in Austrian pharmacies?

No. VIZZ has the green light from the FDA in the USA and will be available there from the end of 2025. No one has yet mentioned approval in Austria.

Drops or surgery – which is more expensive?

In the short term, the drops seem cheap. But calculated over 10 years, the cost is USD 8000-12000 compared to USD 3000-8000 for the surgery. The math is in favor of surgery.

Are the drops a complete solution for eye problems?

Unfortunately not. It is like aspirin for migraines – it provides relief but does not eliminate the cause. The drops only work for presbyopia and only for a few hours. Other visual defects? They remain.

How do you choose the best surgical method?

It’s like choosing a car – it depends on your needs. PresbyLASIK is a universal compact car, Allotex TransForm™ is an elegant coupé with conversion options and lens replacement is an SUV that can overcome anything. At EyeLaser Vienna, we select the method after a detailed analysis.

Can the safety of the interventions be trusted?

Absolutely. These are not experiments, but proven methods with a long track record. The risk? Minimal, especially in experienced hands. At Eyelaser, we have thousands of satisfied patients.

How much time do I need until the healing process is largely complete?

PresbyLASIK: a few days and you are ready. Allotex TransForm™: from a few days to a few weeks. Lens exchange: a few weeks for full recovery. But in any case, you will quickly return to normal life.

What if it is sufficient to correct only one eye?

A great idea! The monovision strategy works brilliantly – one eye for distance, the other for close-up. It works particularly well with Allotex TransForm™. The brain quickly learns to focus on the right eye for the situation at hand.

What if my eyesight changes in the future?

Don’t worry! Laser surgery and lens replacement give a permanent effect. Allotex TransForm™ can be removed if necessary. And if new problems arise? You can always make a correction or use a different method.

INFO: Please remember: This information is for educational purposes and does not replace a visit to the doctor. Every case is different and requires an individual assessment.