PRESBYOND is less commonly recommended over 60, because lens ageing and early cataract often make lens replacement a more appropriate long‑term solution.
Reasons it is used less in this age group
The crystalline lens becomes the main limitation.
- Higher likelihood of cataract or lens‑related glare reducing visual quality
- Corneal laser cannot correct lens opacity or scatter
- Cataract surgery after PRESBYOND may alter the blended‑vision balance
- Lens replacement can address both presbyopia and cataract in one operation
- Risk-benefit analysis often favours treating the lens rather than reshaping the cornea
Possible exceptions
Some older patients may still be candidates.
- Very clear lenses with strong preference to avoid intraocular surgery
- Good overall ocular health and stable prescription
- Full understanding that future cataract surgery could modify results
- Careful evaluation of night‑vision needs and occupational demands
- Decision made jointly with a refractive surgeon after detailed counselling
