Thin corneas often limit or exclude PresbyMAX, because safe laser reshaping requires sufficient tissue thickness.
Why thin corneas are a concern
Excess ablation can destabilise the cornea.
- Higher risk of post‑operative ectasia if residual thickness is too low
- Limited room to correct both distance and presbyopic components safely
- Greater sensitivity to measurement error or regression
- Need to respect strict minimum residual stromal bed thresholds
- Many thin‑cornea patients are better served with non‑corneal options
Alternatives for thin‑cornea presbyopes
Other strategies may be safer.
- ICL or other phakic lenses combined with reading glasses or monovision
- Lens‑based presbyopia solutions such as multifocal or EDOF implants
- Optimised spectacles or contact lenses
- In some cases, no surgery if risks outweigh benefits
- Decision depends on full corneal mapping and safety calculations
