You have been wearing glasses or contact lenses for years and dream of being free from them for good? The essential question to ask before any procedure is: am I a candidate for myopia surgery? This status depends on precise medical criteria, assessed during a comprehensive ophthalmologic evaluation. In this article, discover all the eligibility requirements, contraindications, and steps to determine whether LASIK or PRK surgery is a viable option in your case.
Candidate for myopia surgery: the fundamental eligibility criteria
To be considered a candidate for myopia surgery, several conditions must be met simultaneously. These criteria have been established by ophthalmology professional societies to ensure the safety and efficacy of the procedure. The surgeon systematically verifies them during the preoperative assessment.
- Minimum age of 20–21 years: myopia must be stabilized, which rarely occurs before this age;
- Refractive stability: the progression of myopia must not exceed 0.50 diopters over the past 12 to 24 months;
- Myopia ranging from -1 to -10 diopters: beyond this range, other solutions such as intraocular lens implants may be recommended;
- Sufficient corneal thickness: a minimum of 500 microns is generally required for LASIK;
- No progressive ocular pathology: keratoconus, uncontrolled glaucoma, or cataract constitute major contraindications.
The preoperative assessment: a key step to becoming a candidate for myopia surgery
The myopia preoperative assessment is an in-depth consultation lasting between 60 and 90 minutes. It allows definitive determination of whether you are a good candidate for myopia surgery. This examination relies on several state-of-the-art technologies that map all of your ocular structures.
- Corneal topography: analyzes the curvature and regularity of the cornea to detect subclinical keratoconus;
- Pachymetry: measures corneal thickness at multiple points, a determining parameter for technique selection;
- Aberrometry: evaluates the optical aberrations of the eye to customize the laser treatment;
- Dilated fundus examination: checks the condition of the peripheral retina, which is particularly fragile in highly myopic patients;
- Dry eye testing: quantifies the quality and quantity of the tear film before the procedure.
This assessment is indispensable: it forms the foundation upon which LASIK or PRK eligibility decisions are based. Without it, no reputable surgeon will proceed with the operation.
Contraindications: when you are not a candidate for myopia surgery
Certain medical situations temporarily or permanently prevent a patient from being a candidate for myopia surgery. LASIK contraindications are rigorously evaluated to avoid any risk of postoperative complications.
- Confirmed or suspected keratoconus: this progressive corneal deformation makes laser-induced thinning dangerous;
- Pregnancy or breastfeeding: hormonal fluctuations temporarily alter refraction, constituting a temporary contraindication;
- Autoimmune diseases: systemic lupus erythematosus, rheumatoid arthritis, or Sjögren's syndrome impair wound healing;
- Cornea too thin: insufficient residual thickness after laser ablation exposes the patient to the risk of corneal ectasia;
- Severe dry eye disease: a highly deficient tear film can significantly worsen postoperative discomfort.
When a contraindication to LASIK is identified, PRK may sometimes represent a viable alternative. In other cases, phakic intraocular lenses offer a solution for patients who are not eligible for corneal refractive surgery.
The ideal profile of a candidate for myopia surgery
The ideal candidate for myopia surgery presents a well-defined profile. In practice, the best outcomes are achieved in patients who combine several favorable characteristics. The optimal myopia surgery criteria include:
- Low to moderate myopia (-1 to -6 diopters): the satisfaction rate exceeds 98% in this range;
- Thick and regular cornea: provides a comfortable safety margin for flap creation and laser ablation;
- Normal pupil size: reduces the risk of nighttime halos after the procedure;
- Realistic expectations: understanding that the goal is spectacle independence, not necessarily "perfect" vision for life.
Candidate for myopia surgery with associated astigmatism or hyperopia
Myopia is frequently associated with astigmatism, or even a hyperopic component in the fellow eye. Being a candidate for myopia surgery in these configurations is entirely possible thanks to latest-generation lasers, which are capable of simultaneously treating multiple refractive errors. The myopia preoperative assessment then evaluates each refractive component separately to establish a customized treatment plan. Astigmatism up to 5 diopters and hyperopia up to +4 diopters can be corrected during the same surgical session.
What results can you expect as a candidate for myopia surgery?
Refractive surgery outcomes are remarkably predictable when the patient is a true candidate for myopia surgery who has been properly selected. According to published studies, more than 95% of patients who undergo LASIK for myopia below -6 diopters achieve 20/20 uncorrected visual acuity. Visual recovery is rapid: the majority of patients regain functional vision by the day following the procedure. Serious complications, such as corneal ectasia or infection, remain exceptional when myopia surgery criteria are scrupulously followed. Regular postoperative follow-up ensures the long-term stability of the result.
When should you consult Dr Gozlan about being a candidate for myopia surgery?
It is recommended to schedule a consultation as soon as your myopia appears to have been stable for at least one year and you wish to consider a definitive solution. The sooner the preoperative assessment is performed, the sooner you will know whether you are a good candidate for myopia surgery. Dr Gozlan supports you at every stage, from the initial evaluation through postoperative follow-up, recommending the technique best suited to your ocular anatomy and visual expectations.
📍 Consultation at Cabinet Ophtalmologique Paris – Auteuil
Dr Gozlan, an ophthalmic surgeon specializing in refractive surgery at Cabinet Ophtalmologique Paris – Auteuil, welcomes you for your preoperative assessment and comprehensive care.
Book an Appointment on DoctolibFAQ: candidate for myopia surgery — frequently asked questions
At what age can you become a candidate for myopia surgery?
The recommended minimum age is 20 to 21 years. It is imperative that myopia has been stable for at least 12 months, which is verified by comparing successive optical prescriptions during the preoperative assessment.
Can you be a candidate for myopia surgery with high myopia?
LASIK effectively corrects myopia up to approximately -8 to -10 diopters, provided corneal thickness is sufficient. Beyond this range, a phakic intraocular lens represents a safe and reversible alternative for high myopia.
Does dry eye disease prevent you from being a candidate for myopia surgery?
Mild to moderate dry eye is not an absolute contraindication. It may require prior treatment with artificial tears or punctal plugs. However, severe dry eye constitutes a formal LASIK contraindication.
How much does the assessment cost to determine if you are a candidate for myopia surgery?
The preoperative assessment consultation is billed as a specialist consultation. A portion is covered by the French national health insurance and your supplementary insurance. Dr Gozlan provides transparent information about fees when scheduling your appointment.
What can be done if you are not a candidate for myopia surgery with LASIK?
Several alternatives exist: PRK for thin corneas, phakic intraocular lenses for high myopia, or SMILE for certain intermediate profiles. The preoperative assessment helps guide patients toward the most suitable solution.
Further reading
- LASIK: the most widely performed refractive technique for myopia;
- PRK: an alternative for thin corneas or contact-sport athletes;
- LASIK vs PRK comparison: all the differences explained.