In 2010, conductive keratoplasty (CK) was the hot presbyopia fix — a quick, non-laser procedure using radio waves to reshape the cornea. Today, you’ll struggle to find a US practice still offering it. CK largely disappeared from the American market after Refractec, the manufacturer, discontinued the system. If your ophthalmologist quoted you CK, double-check the year of that information.
But presbyopia surgery is alive and evolving — just under different names. Here’s what’s actually available in 2026 and what it costs.
Current Presbyopia Surgical Options and Pricing
| Procedure | Cost Per Eye | Both Eyes / Notes |
|---|---|---|
| Monovision LASIK (standard) | $1,800–$3,000 | Only one eye corrected; low cost route |
| Monovision LASIK (custom wavefront) | $2,200–$3,500 | Better quality of vision |
| PresbyLASIK / multifocal ablation | $2,500–$4,000 | Both eyes needed; blended vision |
| KAMRA Corneal Inlay | $3,500–$5,000 | One eye (non-dominant); FDA-approved |
| Refractive Lens Exchange (RLE) with multifocal IOL | $3,000–$5,500/eye | Permanent; removes natural lens |
| Vuity (pilocarpine 1.25% drops, Rx) | $75–$90/month | Non-surgical; temporary near improvement |
Conductive keratoplasty, when it was available, ran $1,500–$2,500 per eye. The AcuFocus KAMRA inlay has taken over much of that space for patients who want a cornea-based approach without removing the natural lens.
Who Gets Presbyopia — and When
The AOA estimates that more than 128 million Americans have presbyopia, making it the most common vision condition overall. It’s not a disease — it’s the inevitable stiffening of the crystalline lens that begins for most people in their early-to-mid 40s. By age 50, virtually everyone has it to some degree.
That enormous prevalence is why the presbyopia procedure market is booming. It’s also why you’ll see heavy advertising for anything that promises to reduce reading glass dependence.
Breaking Down the Main Options
Monovision LASIK is the lowest-cost surgical route. One eye (typically the dominant eye) is corrected for distance; the non-dominant eye is left mildly nearsighted for reading. Your brain adapts. The tradeoff is some loss of binocular depth perception and stereo vision. Many patients over 45 choose this approach when they’re already getting LASIK for distance correction. Add-on cost for monovision targeting is usually $0–$500 over standard bilateral LASIK pricing.
KAMRA Inlay is a small ring-shaped device implanted in the cornea of the non-dominant eye. It works on the pinhole effect — restricting peripheral light to extend depth of focus. FDA approval came in 2015. It’s a real option for patients with minimal refractive error who don’t want to remove their natural lens. At $3,500–$5,000 per eye (single eye), it’s among the pricier corneal-based options.
Refractive Lens Exchange essentially turns presbyopia correction into a cataract-type surgery — the natural lens is removed and replaced with a premium multifocal or extended-depth-of-focus (EDOF) IOL. It’s permanent and eliminates future cataract risk, but it’s the most invasive option and costs $3,000–$5,500 per eye. Most appropriate for patients in their 50s+ who are not LASIK candidates.
Before any monovision-based procedure, your doctor should offer a contact lens monovision trial. One contact corrects near, one corrects distance — you wear this for 1–2 weeks to test whether your brain adapts comfortably. Roughly 70–80% of patients who tolerate the trial do well with surgical monovision. If you hate the contacts, don’t proceed with irreversible surgery. This trial typically costs nothing beyond a standard contact lens exam.
What Insurance Covers
Almost nothing surgical for presbyopia correction is covered by insurance. These procedures are classified as elective vision correction. Medicare does not cover LASIK, corneal inlays, or refractive lens exchange for presbyopia.
The partial exception: if you develop cataracts and need lens extraction anyway, your surgeon may offer a premium multifocal IOL at an upgrade cost of $1,500–$2,500 per eye above what Medicare covers for a standard monofocal lens.
FSA and HSA funds can pay for any of these procedures, providing a meaningful pre-tax discount depending on your tax bracket.
The Drops Alternative
The FDA approved Vuity (pilocarpine 1.25%) in 2021 — the first prescription eye drop for presbyopia. It works by constricting the pupil, which increases depth of focus. Results are modest (improvement of ~1.5–2 lines on a reading chart in clinical trials) and last about 6 hours. Monthly cost is $75–$90 with a prescription.
For patients with mild presbyopia who wear contacts or glasses anyway, Vuity can reduce reading glass dependence during specific activities. It doesn’t replace surgery-level correction.
Be skeptical of any presbyopia procedure that promises complete independence from reading glasses at all distances in all lighting. Published clinical data consistently shows that all current surgical options involve tradeoffs — reduced contrast sensitivity, halos, or some residual dependence on glasses for specific tasks. Ask your surgeon for realistic expectations, not marketing language.
Getting the Best Value
- Compare at least two presbyopia specialists — pricing varies significantly between practices even in the same metro area
- Ask about the full procedure package — what’s included in follow-up care? Enhancement policy?
- Evaluate timing: Doing monovision LASIK at the same time as distance LASIK adds minimal cost compared to a separate procedure later
- Don’t rush to the newest option: KAMRA and PresbyLASIK are both mature technologies at this point — well-studied and predictable in the right candidates
Presbyopia is manageable with glasses or contacts indefinitely. Surgery is a choice of convenience and lifestyle — price it accordingly.