PRESBYOND is generally contraindicated in keratoconus, because additional corneal reshaping can worsen ectasia and irregularity.
Risks in keratoconus
Laser may aggravate the disease.
- Already weakened and thinned cornea is vulnerable to further biomechanical stress
- Irregular astigmatism reduces the predictability of blended‑vision optics
- Higher risk of progression, ghosting, and reduced quality of vision
- Standard refractive guidelines list keratoconus as a major contraindication
- Visual symptoms may worsen despite the intention to help presbyopia
Preferred management options
Safer approaches are available.
- Rigid or scleral contact lenses to regularise optics
- Corneal cross‑linking to stabilise progression where indicated
- Lens‑based procedures for refractive and presbyopic needs, if appropriate
- Use of reading glasses or multifocal contacts for near work
- Care under a corneal and refractive specialist rather than corneal laser
