PresbyMAX is not the best option when corneal safety is questionable, presbyopia is mild, or lens‑based solutions offer clearer long‑term benefits.
Clinical situations favouring alternatives
Cornea or lens status guide choice.
- Thin, irregular, or ectatic corneas unsafe for laser
- Early cataracts where lens replacement is more logical
- High refractive errors better suited to ICL or lens implants
- Significant retinal or optic‑nerve disease limiting visual potential
- Severe dry eye or autoimmune surface disease
Preference‑based reasons
Goals and tolerance may point elsewhere.
- Very mild presbyopia manageable with simple readers
- High reliance on night driving and intolerance of potential halos
- Strong desire for reversibility rather than permanent corneal reshaping
- Happiness with spectacles or contact lenses without major inconvenience
- Better alignment with ICL or lens replacement given age and lifestyle
