PresbyMAX can sometimes be performed in stable, early glaucoma, but significant or unstable disease often makes it unsuitable.
Issues in glaucoma patients
Monitoring and safety are more complex.
- Corneal thickness and biomechanics change after laser, affecting pressure readings
- Glaucoma damage may already limit visual potential and contrast
- Field testing and structural monitoring become harder to interpret
- Advanced or poorly controlled glaucoma increases risk of disappointing outcomes
- Some glaucoma medications affect ocular surface health needed for laser
When it may still be considered
Careful selection is essential.
- Well‑controlled, early glaucoma with stable fields and optic nerve
- Open angles and no major structural progression
- Strong presbyopia‑related symptoms and clear potential benefit
- Coordination with a glaucoma specialist regarding risks and follow‑up
- Understanding that glaucoma care remains the priority long term