PRESBYOND can sometimes be combined with existing ICLs to address presbyopia, but this approach is complex and highly individualised.
When it might be considered
Corneal enhancement can complement ICL distance correction.
- Good distance vision with ICLs but increasing dependence on reading glasses
- Stable ICL position and appropriate vault with healthy endothelial counts
- Suitable corneal thickness and regular topography
- Clear natural lenses without cataract
- Preference to retain ICLs rather than move to lens replacement
Considerations and alternatives
Multiple procedures increase complexity.
- Future lens surgery becomes more complicated after both ICL and corneal laser
- Optical balance between internal and corneal elements can be challenging
- Lens‑based presbyopia solutions may ultimately be more straightforward
- Extensive counselling about potential night‑vision effects is required
- Suitability must be judged in an experienced refractive centre on a case‑by‑case basis
