PresbyMAX is less commonly recommended over 60, because cataract formation and lens changes often make lens replacement more appropriate.
Reasons it is used less in this age group
The lens usually becomes the main issue.
- Higher likelihood of cataracts reducing clarity and contrast
- Corneal laser cannot correct lens clouding or increasing scatter
- Lens replacement can address both presbyopia and cataract in one step
- Future cataract surgery after PresbyMAX requires additional planning
- Risk-benefit balance often favours treating the lens rather than reshaping the cornea
Possible exceptions
Some carefully selected patients may still be considered.
- Very clear lenses with strong desire for corneal, not lens‑based correction
- Medical reasons why intraocular surgery is less desirable at present
- Full understanding that later cataract surgery could modify results
- Excellent overall ocular health otherwise
- Decision made after thorough counselling about alternatives
