PRESBYOND is usually unsuitable in significantly irregular corneas, because blended‑vision laser patterns require a regular surface for predictable optics.
Why irregularity is problematic
Outcomes become less reliable.
- Irregular astigmatism increases higher‑order aberrations and ghosting
- Laser may exacerbate irregularity and reduce vision quality
- Irregular topography can indicate early ectasia, which laser may worsen
- Achieving a stable blended‑vision profile is technically difficult
- Patient satisfaction is often poor when irregularity is significant
Alternative options
Other treatments manage irregular corneas better.
- Rigid, scleral, or hybrid contact lenses to smooth optical irregularity
- Topography‑guided procedures or cross‑linking in strictly selected cases
- Lens‑based refractive options combined with specialist contact lenses
- Ongoing monitoring for progression of irregularity
- Individualised care within a corneal specialist service
