Who should not get LASIK?

While LASIK has become a household name for vision correction, it is important not to forget that not every person is eligible or suitable for LASIK.

For those whom I would steer away from LASIK, they can be described in two categories:

1. Anatomical
2. Expectation

Anatomically unsuitable candidates would include:

• Individuals with a thin cornea relative to their prescription
• Individuals with a high degree of myopia or those with more than a moderate level of hyperopia.
• Individuals with chronic dry eye symptoms or conditions leading to hypersensitivity of the ocular surface

A note on what is considered a high degree of myopia and hyperopia may vary by surgeon and their scope. With the full scope of techniques, I conservatively set my degrees for LASIK-eligible myopia and hyperopia. Pushing the limits of LASIK treatment range has a diminishing return on efficacy and an increasing rate of side effects. Alternative techniques such as ICL, SMILE, or CLR may be worth exploring in these cases.

Expectation

LASIK corrects for a static diopter of refractive error. It does not correct for age-related changes that can occur to the vision over time. LASIK can carry visual and sensory trade-offs that need to be understood.

• Age & refraction stability. An individual may still be undergoing the steep curve of developmentally-related refractive changes, while others are experiencing age-related visual changes.
• The onset of presbyopia or cataracts. Individuals seeking correction for age-related changes to vision should consider lens-based procedures to address their visual needs.
• Potential visual side effects such as halos and starbursts. Each person perceives starbursts and halos differently, and tolerance needs to be individually considered.
• Potential sensation side effects from the healing response, such as ocular sensitivity. This requires attention to ocular moisture and avoiding overuse of the eyes during recovery.

For those seeking visual freedom, understand that LASIK is simply one of six modern-day vision correction techniques, which include ICL, SMILE, PRK, CLR/RLE, and premium cataract surgery. The options for vision correction have evolved to serve more individuals' needs. It is critical to find a surgeon who can practice to the full scope of today's techniques and technology and determine your suitability for vision correction.