PresbyMAX can sometimes be used after ICL surgery, but combining intraocular and corneal procedures increases complexity and requires meticulous planning.
Possible indications
It can fine‑tune presbyopic needs.
- Good distance vision with ICL but increasing dependence on reading glasses
- Stable ICL position and appropriate vault
- Healthy cornea with sufficient thickness and regular shape
- Clear natural lens without cataract
- Desire to retain ICL rather than move to lens replacement
Considerations and alternatives
Risks and future options must be weighed.
- Further surgery reduces simplicity if lens replacement is later needed
- Multifocal corneal optics plus internal lens power can be harder to balance
- Lens‑based presbyopia solutions may ultimately be more straightforward
- Extensive counselling about potential night‑vision effects is essential
- Suitability judged on a case‑by‑case basis in an experienced refractive centre
