PresbyMAX can sometimes be performed in well‑controlled autoimmune disease, but active or severe disease often makes corneal laser unsuitable.
Risks with autoimmune conditions
Healing and inflammation may be unpredictable.
- Higher likelihood of dry eye, delayed epithelial healing, or sterile infiltrates
- Potential for post‑operative inflammation affecting vision
- Systemic immunosuppressants altering infection risk
- Specific conditions (for example rheumatoid arthritis, Sjögren’s) heavily linked with ocular‑surface problems
- Laser may destabilise previously compensated ocular surface
When it may still be considered
Decision requires a multidisciplinary approach.
- Stable disease with minimal ocular involvement
- Strong motivation and suitable corneas
- Input from rheumatologist and ophthalmologist on timing and medication cover
- Willingness to accept higher uncertainty and need for close follow‑up
- In many cases, lens‑based or non‑surgical options remain preferable
