PresbyMAX can occasionally be performed after vitrectomy, but suitability depends heavily on retinal status and overall visual potential.
Challenges after vitrectomy
Posterior pathology often dominates.
- Vitrectomy is frequently done for macular holes, detachments, or haemorrhage
- These conditions may permanently limit acuity or contrast
- Corneal laser cannot correct retinal or optic‑nerve damage
- Residual distortions may make multifocal optics less tolerable
- Risk-benefit analysis must consider previous surgical history
Scenarios where it might be reasonable
Only if the eye remains visually promising.
- Stable retina with good post‑vitrectomy acuity and minimal distortion
- Clear cornea and lens, with presbyopia now the main annoyance
- Retinal surgeon agrees there is adequate reserve
- Patient fully understands that laser will not fix any remaining retinal changes
- Alternative refractive solutions discussed in parallel
