PresbyMAX is generally not recommended in significant macular degeneration, because retinal disease rather than focusing is the main visual limitation.
Why benefit is limited
Laser cannot repair the macula.
- Central distortion, missing areas, or low contrast will persist after surgery
- Multifocal corneal optics may further reduce contrast sensitivity
- Progressive macular disease can erode any refractive gains
- Surgical risk may not be justified when potential acuity is poor
- Low‑vision aids and retinal treatments typically provide more benefit
Rare scenarios for consideration
Only very mild disease may be considered.
- Early, stable changes with good baseline acuity
- Strong, informed wish for refractive correction despite risk
- Close collaboration with a medical retina specialist
- Realistic discussion that expectations must remain modest
- Usually, alternatives are preferred over PresbyMAX in this group
