Refractive Surgery
Eyes that no longer need to be managed.
A laser blended-vision treatment for early-to-moderate presbyopia — freedom from reading glasses for the right eyes, often combined with distance correction in the same procedure. Refractive surgery at Palazzo Manzoni in Brescia, with an ophthalmology department led by Dr. Andrea Russo.
Laser refractive surgery at Palazzo Manzoni in Brescia corrects myopia, hyperopia, astigmatism and early-to-moderate presbyopia with four Zeiss-based techniques: SMILE, Femto-LASIK, PRK and Presbyond. The ophthalmology department, led by Dr. Andrea Russo, MD, PhD, designs each laser plan around the patient’s eyes and life, not around a single default technique.
Both eyes
A blended distance-and-near profile
Zeiss
Exclusive technology partner
1 specialist
From examination through recovery
1–2 days
Typical return to daily activity
The Discipline
You’ve been adapting for a long time.
Maybe the first thing you reach for in the morning is your glasses. Maybe your contact-lens kit travels with you everywhere. Maybe you’ve started holding your phone a little further from your face. None of it feels unusual anymore, which is its own kind of signal.
Most refractive errors don’t improve on their own. Presbyopia doesn’t pause. Each year is another year your eyes work around the problem instead of being corrected. Waiting isn’t neutral.
At Palazzo Manzoni in Brescia, the first step is simply a full diagnostic assessment, where we understand your eyes and your life before we recommend anything. It takes about an hour, and it commits you to nothing.
What Makes Presbyond Different
The difference is how both eyes work together
Older monovision approaches simply set one eye for distance and the other for near, and asked the brain to ignore whichever eye was blurred. It works for some, but many people never adapt to the gap between the two.
Presbyond is different. A Zeiss laser creates a controlled blend zone in each eye and a deliberate overlap between them. Rather than competing, the two eyes combine into one continuous range of vision — near, intermediate and distance.
Three things follow from that. Adaptation rates are far higher than with conventional monovision. The treatment can correct distance vision at the same time. And for the right eyes, it postpones or avoids lens-based surgery entirely.
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Blended, not split
Both eyes combine into one continuous range.
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Glasses-free range
Near, intermediate and distance, together.
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One department, one pathway
Diagnostics, treatment and aftercare, led by Dr. Andrea Russo.
Step by Step
What happens during your Presbyond procedure, minute by minute.
Step 01
Your blend profile is planned
Your specialist measures both eyes and designs a blended-vision profile tuned to your prescription, your dominant eye and the way you use your vision day to day.
Step 02
The laser shapes each eye
A Zeiss femtosecond and excimer laser combination shapes each cornea and its blend zone — a few minutes per eye, talked through at every step.
Step 03
Your vision settles
Day surgery at Palazzo Manzoni; you go home the same day. Over the following days your brain learns to combine the two eyes into one continuous range.
Step 04
Glasses-free, near and far
Reading a menu, checking your phone, driving — the small moments that used to mean reaching for glasses start to take care of themselves.
Is Presbyond Right for Your Eyes?
Is Presbyond
right for your eyes?
Presbyond is a specific answer for early-to-moderate presbyopia, and the match matters. At Palazzo Manzoni, most Presbyond candidates share several of the following.
Clinical profile
- Early-to-moderate presbyopia, with or without distance correction to combine
- Distance prescription within range to blend alongside the near correction
- A stable prescription for at least 12 months
- Sufficient corneal thickness for laser treatment (evaluated individually)
- Typically in the forties or early fifties, before the natural lens begins to cloud
- No active eye disease, uncontrolled inflammation or untreated severe dry eye
Life profile
- An active lifestyle such as running, cycling, climbing, swimming or skiing
- Contact sports where the theoretical risk of flap dislocation is a real consideration, including combat sports, rugby and water polo
- Professional roles with physical or environmental demand, including military, law enforcement and emergency response
- An understanding that a mild, short-lived dry-eye sensation can occur in the first few weeks and usually settles within a month
- A careful disposition: the kind of patient who wants the least surface disturbance consistent with a real result
Where Presbyond isn’t the right answer?
Presbyond works best for early-to-moderate presbyopia, before the eye’s natural lens begins to cloud. For later-stage presbyopia, significant cataract, or eyes that do not tolerate a blended-vision profile, a premium lens based technique is usually better suited. Your assessment at Palazzo Manzoni will identify which one.
If Presbyond fits, your assessment will confirm it. If not, the right answer for your eyes still exists, and the assessment will find it.
More Than a Decade of Evidence
More than a decade of evidence, on the original platform
Presbyond is Zeiss’s laser blended-vision treatment, built on the same femtosecond and excimer laser platforms used for Femto-LASIK and refined over more than a decade of clinical use. At Palazzo Manzoni it runs on current-generation Zeiss systems, with a growing international evidence base and adaptation rates well above older monovision approaches.
At Palazzo Manzoni, the entire refractive pathway sits on Zeiss systems, from preoperative imaging to follow-up measurements. What varies between clinics is not the technology. It is the experience of the team running it.
Day by Day
The first 24 hours, the first week, and the months that follow
The evening after surgery
Blurred or fluctuating vision is normal, as is a light gritty sensation, as if something is mildly irritating your eye. Both fade within a few hours. You use the drops provided, avoid screens and sleep early.
The next morning
Most Presbyond patients see clearly across distance and near within a day or two. The brain takes a little longer — over the following days and weeks it learns to blend the two eyes into one continuous range. Light to moderate exercise is generally back on the table within a day or two.
The first week
Vision sharpens progressively. Dry-eye sensation, when present at all, is typically milder and shorter-lived than after flap-based techniques. You attend your first follow-up at Palazzo Manzoni. Swimming, sauna and heavy contact sport are paused for a short defined period.
First month
Visual stability is reached for most patients. Night vision continues to refine. You attend a second follow-up.
3 to 6 months
The long-term refractive result is locked in. A final follow-up closes the surgical phase of your care. Palazzo Manzoni remains open to you for any future check-up.
Honest Trade-offs
What Presbyond
doesn’t do
Every laser has its trade-offs, and honesty about them matters more than marketing.
Presbyond asks the brain to adapt to a blended-vision profile, and most people do so within days. A minority never fully adapt to the deliberate overlap between the two eyes, and a small number notice halos or reduced crispness in dim light. For these patients, full distance correction with reading glasses, or a premium lens based approach, can be the better answer.
Presbyond, like any surgical procedure, is not risk-free. Serious complications are rare, well below 1 percent in the current literature, but they exist. The more common post-operative experiences are temporary dry-eye sensation, mild night-vision halos during the first weeks, and a period of neural adaptation to the blended-vision profile. Rarer but real risks include infection, flap-related complications and residual refractive error that can usually be corrected with an enhancement. The Palazzo Manzoni team walks you through the specific risk profile for your eyes before anything is scheduled.
Who Leads the Department
Dr. Andrea Russo
Ophthalmologist. Founder of Palazzo Manzoni. Specialist in laser refractive surgery, ICL and cataract surgery.
International surgical training
including Moorfields Eye Hospital, London
International scientific research
collaborates and conducts research with the world’s leading scientists and refractive surgeons, 1,200+ peer-reviewed citations
Professional societies
fellow of the World College of Refractive Surgery (FWCRS), member of the American-European Congress of Ophthalmic Surgery (AECOS) and the European Society of Cataract and Refractive Surgeons (ESCRS)
Inventor
creator of D-Eye, a smartphone-based retinal imaging device used in clinical practice worldwide
15,000+
procedures performed
“Every pair of eyes tells a different story. Our role is to understand yours fully, explore every option that could improve your vision, and guide you with confidence toward the one that fits your life best.”
Patient Stories
They were where
you are now
Glasses and contacts have been part of your life for years. Or reading has started to slip and you want a solution that doesn’t involve lens surgery. Laser vision correction can change both.
Real experiences from patients who took the step
I wore glasses for 18 years. I didn’t realize how much I’d been adapting until the morning after my procedure, when I opened my eyes and could see the ceiling clearly for the first time.
I came in expecting to just fix my cataract. My specialist explained the option of a multifocal lens, and now I see better than I did at 50. I haven’t touched my reading glasses since.
Two clinics told me laser wasn’t possible because of my prescription. At Palazzo Manzoni they offered ICL, and now I see perfectly. I wish I’d known about this option sooner.
Options
If Presbyond isn’t right, there’s still a path
Presbyond fits a specific window, and not every eye or every decade falls inside it. If your age, your lens or your corneal picture points elsewhere, another route usually fits you better.
→Premium and multifocal lenses
When the natural lens is already clouding or a cataract is forming, correcting presbyopia and the lens together.
→Femto-LASIK
When distance vision is the real need and a presbyopic blend is not yet warranted.
→SMILE
When a flapless distance correction suits myopia and astigmatism better.
→PRK
When the cornea is thin or the surface needs treatment, for distance correction.
Your assessment will clarify which path is right.
Common Questions
Common questions
about ophthalmology
What vision problems can be treated at Palazzo Manzoni?
The ophthalmology department treats the full range of refractive errors (myopia, hyperopia, astigmatism, presbyopia) and cataracts. Treatments include laser refractive surgery (SMILE, Femto-LASIK, PRK, Presbyond), ICL phakic lens implantation for high or unusual prescriptions, and cataract surgery with standard or premium multifocal lenses.
How do I know which treatment is right for me?
That is exactly what your first eye examination is for. It assesses your prescription, corneal shape and thickness, lens clarity, and overall eye health, then places those findings in the context of your age, lifestyle, and visual goals. You leave with a clear explanation of your options and an honest recommendation, not a sales pitch.
Am I a candidate for laser vision correction?
Most patients between 20 and 45 with stable myopia, hyperopia, or astigmatism are good candidates. The pre-operative examination looks at corneal thickness, prescription stability, and eye health to confirm suitability. If laser is not ideal for you, ICL lens implantation is often an excellent alternative.
What if another clinic told me surgery isn’t an option for me?
It is worth a second opinion. High prescriptions, thin corneas, or unusual anatomies often rule out standard laser surgery, but do not rule out vision correction. Patients in this situation are frequently successful candidates for ICL, a phakic intraocular lens implanted without removing corneal tissue.
What is the difference between standard and premium lenses for cataract surgery?
A standard intraocular lens restores clear distance vision after cataract removal, but you will still need reading glasses for close-up tasks. A premium multifocal lens corrects distance, intermediate, and near vision in the same surgery, reducing or eliminating dependence on glasses. The right choice depends on your lifestyle.
What happens during my first eye examination?
Your first visit lasts about an hour. It includes a detailed diagnostic examination with advanced imaging, a discussion of your vision goals and daily life, and a personalized explanation of the treatment options available to you. There is no pressure to decide anything during the visit. You leave with the information you need to make a calm, informed choice on your own timeline.
Is the procedure painful, and how long does recovery take?
Procedures are performed under local anaesthetic eye drops, so you feel no pain, only light pressure. Most laser patients see improvement within hours and return to normal activities within one to two days. Cataract patients typically see clearly by the next day. Full visual stabilization can take a few weeks depending on the procedure.
How much does treatment cost?
Costs depend on the procedure and, for cataract surgery, on the type of lens chosen. After your initial examination, once the appropriate treatment has been identified, you receive a detailed, transparent cost estimate with no hidden fees.
Where is Palazzo Manzoni located, and do I need a referral?
Istituto Chirurgico Palazzo Manzoni is at Via dei Mille 14 in central Brescia, easily reached by car or public transport from anywhere in Lombardy, including Milan (about one hour away). No referral is required. You can book directly by phone, email, or online form.
Who leads the ophthalmology department?
The ophthalmology department is led by Dr. Andrea Russo, MD, PhD, ophthalmologist, researcher, and founder of Palazzo Manzoni. Dr. Russo specializes in laser refractive surgery, ICL lens implantation, and cataract surgery with premium IOLs, and collaborates and conducts research with the world’s leading scientists and refractive surgeons. His research on refractive surgery and ocular imaging is internationally cited.
Take the Next Step
Your next step starts
with a conversation
At Palazzo Manzoni in Brescia, every consultation is personal, unhurried, and designed to give you clarity about your next step.
Address
Via dei Mille 14, 25122 Brescia, Italia
Phone
Hours
Mon-Fri 8:30-18:30 · Sat 9:00-13:00
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Get in touch
Call, email, WhatsApp, or book online.
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Meet your specialist
A personal consultation to understand your situation.
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Your plan, your pace
Together you decide the best path forward.
Scientific research
The Presbyond technique relies on controlled corneal spherical aberration: on this very topic, Dr. Andrea Russo is first author of a 484-eye study published in Ophthalmology and Therapy (2021). The team’s full list of publications is available on PubMed.
Content reviewed by Dr. Andrea Russo and Dr. Pierdavide Perrini, refractive surgeons at the Institute.