PRESBYOND is generally not recommended in significant macular degeneration, because retinal disease rather than focusing is the main limitation.
Why benefit is limited
Laser cannot repair macular damage.
- Distortion, scotomas, and reduced contrast will persist after surgery
- Blended‑vision optics may further reduce contrast sensitivity
- Progressive macular disease can quickly negate refractive gains
- Procedural risk may not be justified when potential acuity is poor
- Low‑vision aids and retinal therapies usually offer more meaningful benefit
Rare situations for consideration
Only very mild, stable disease may be discussed.
- Good corrected acuity with minimal macular changes
- Retinal specialist agrees additional risk is acceptable
- Patient understands benefits are modest and uncertain
- Ongoing retinal monitoring remains the priority
- Often, surgery is deferred in favour of conservative management
