Thin corneas often limit or exclude PRESBYOND, because safe laser ablation requires adequate tissue thickness.
Why thin corneas are a concern
Excess tissue removal risks instability.
- Higher chance of post‑operative ectasia if residual stromal bed is too thin
- Restricted ability to correct both distance and presbyopic components safely
- Increased sensitivity to measurement errors and regression
- Need to respect strict minimum thickness guidelines
- Many thin‑cornea patients are better suited to non‑corneal options
Alternatives for thin‑cornea presbyopes
Other strategies may be safer.
- ICL or other phakic IOLs with or without reading glasses or monovision
- Lens‑based presbyopia solutions such as multifocal or EDOF implants
- Optimised spectacle or contact‑lens strategies
- In some cases, no surgery if risk outweighs benefit
- Full corneal mapping is essential before deciding
