Am I a candidate for refractive surgery?

The first decision is safety, not technique.

Patients often ask whether PRK or LASIK is better. That question matters, but it comes after a more important one: do your eyes show that surgery is safe?

Eligibility depends on examination findings, prescription stability, corneal health, ocular surface, visual habits and realistic expectations. In some cases laser surgery is appropriate; in others, dry eye treatment, observation, phakic lenses or no surgery may be the better decision.

Factors that support good candidacy

• Stable prescription: recent changes in glasses or contact lenses require caution.
• Regular cornea: topography and tomography help screen for keratoconus or suspicious asymmetry.
• Adequate thickness: the cornea needs to keep a safety margin after laser treatment.
• Controlled ocular surface: dry eye, blepharitis and allergy can worsen symptoms and affect healing.
• Realistic expectations: the goal is to reduce dependence on glasses, not promise perfect vision in every situation.

Warning signs that deserve caution

Some findings do not automatically rule out surgery, but they require careful discussion: thin corneas, suspected keratoconus, large pupils with night symptoms, significant dry eye, inflammatory eye disease, previous eye surgery, medications that affect healing, pregnancy, breastfeeding or contact sports.

PRK, LASIK or phakic lens?

PRK and LASIK reshape the cornea with laser. A phakic lens corrects prescription without reshaping the cornea and may be discussed when prescription is high, the cornea is thin or an intraocular option makes more sense for that patient.

The technique should not be chosen by preference alone. It should follow the examination and the acceptable risk for that eye.

Useful questions for the visit

• Are my topography and tomography safe?
• Has my prescription been stable long enough?
• Do I have dry eye that should be treated first?
• Does my work, sport or routine change the indication?
• In which situations might I still need glasses?
• If I am not a laser candidate, does a phakic lens make sense?

Practical summary

Being a refractive surgery candidate is not defined by prescription alone. It depends on cornea, stability, ocular surface, lifestyle and expectations. The best indication puts safety before the desire to operate.

Sources and notes

Educational content only; it does not replace individualized medical care. References consulted: FDA - What is LASIK?, FDA - When is LASIK not for me? and FDA - Risks of LASIK.