PRESBYOND is usually not ideal when early cataracts are present; lens‑based surgery typically offers a better long‑term solution.
Why early cataract reduces suitability
The lens, not the cornea, becomes the main problem.
- Cataracts will progress and eventually require lens replacement
- Corneal laser cannot improve lens opacity or internal scatter
- Later cataract surgery may disrupt the carefully balanced blended vision
- Refractive lens exchange can address both distance and near while treating cataract
- Two separate procedures (PRESBYOND then cataract) may be less efficient and carry cumulative risk
Possible exceptions
Occasionally corneal laser is still considered.
- Very early, clinically insignificant lens changes
- Strong preference to avoid intraocular surgery for now
- Informed acceptance that future cataract surgery may alter results
- Regular monitoring of lens status after laser
- Decision made case by case with a refractive surgeon
