PresbyMAX may be possible in ocular hypertension, but requires careful assessment of pressure risk and future glaucoma monitoring.
Points of caution
Laser alters corneal parameters.
- Post‑laser corneal thinning can make pressure readings appear lower than true
- Pre‑existing tendency to high pressure reduces safety margin
- Need for long‑term surveillance to detect glaucoma early
- Dry‑eye‑inducing drops may complicate surface quality for surgery
- Risk-benefit analysis must consider decades of future IOP monitoring
Factors supporting suitability
Some ocular hypertension patients remain candidates.
- Healthy optic nerves and normal visual fields
- Pressures controlled at acceptable levels
- Good corneal thickness and shape aside from planned ablation
- Agreement to ongoing eye‑pressure follow‑up after surgery
- Close collaboration with the clinician managing ocular hypertension