PresbyMAX‑style presbyopic laser enhancements can sometimes be performed after LASIK, but require very careful assessment.
When post-LASIK PresbyMAX may be considered
It can extend range in previously treated eyes.
- Stable post‑LASIK refraction with adequate residual corneal thickness
- Regular topography and no signs of ectasia
- Clear lenses and good retinal health
- Presbyopia now causing increased dependence on readers
- Desire to avoid lens replacement at this stage
Additional challenges
Safety thresholds are tighter.
- Less residual tissue available for further ablation
- Higher sensitivity to dry eye and flap‑related issues
- Corneal biomechanics already altered by prior surgery
- Need for extremely accurate measurements and realistic expectations
- In some cases, lens‑based options may be safer than additional corneal laser
