PresbyMAX after corneal cross-linking may be possible in selected, stable cases, but it is a complex decision.
When PresbyMAX might be considered
After successful cross-linking, some patients with previously unstable keratoconus or ectasia later seek presbyopia correction. If the cornea has remained stable for several years, limited customised treatment may be discussed.
- Regular topography must show no further progression
- Corneal thickness needs to meet strict safety margins
- Realistic goals usually focus on modest improvements, not perfection
- Specialised centres with experience in post-cross-linking lasers are preferred
Reasons for caution
Cross-linked corneas are often irregular and biomechanically altered. Additional laser treatment can risk quality of vision or structural stability.
- Some patients are advised against further corneal reshaping
- Lens-based presbyopia options may be safer in many cases
- Detailed counselling about potential side effects is essential
- Regular long-term monitoring remains important whatever option is chosen
