Am I a candidate for laser eye surgery?

Candidates for laser refractive surgery (LASIK, PRK, SMILE) must meet several criteria: minimum age 18 (ideally 21 and over), correction stable for at least one year, cornea of sufficient thickness, no progressive corneal condition (keratoconus), no uncontrolled autoimmune disease, no ongoing pregnancy or breastfeeding. A complete preoperative assessment (topography, pachymetry, aberrometry) definitively confirms eligibility.

The minimum legal age is 18, but Dr Tourabaly recommends waiting until at least 21 to ensure refractive stability. Before this age, short-sightedness may still progress, reducing the benefit of surgery. Children and adolescents are not candidates except in exceptional cases (severe anisometropia, visual disability). There is no upper age limit as long as the state of the cornea and the lens allow the procedure, often up to 55-60 years for LASIK.

The main absolute contraindications are: keratoconus or suspected progressive keratoconus, a cornea that is too thin (pachymetry below 480-500 µm), severe uncontrolled dry eye, active autoimmune diseases (lupus, unstabilised rheumatoid arthritis), pregnancy and breastfeeding, poorly controlled diabetes with retinopathy, severe immunosuppression. Some contraindications are relative and may point towards PRK or a phakic ICL implant.

Beyond -8 to -10 dioptres, LASIK reaches its limits of corneal safety. For high short-sightedness (up to -18 dioptres), the phakic ICL EVO implant is often a suitable alternative. It is an implantable lens placed between the iris and the natural lens, reversible, preserving the cornea. Dr Tourabaly carries out the complete feasibility assessment: biometry, endothelial cell density, topography, anterior chamber depth.

Yes, temporarily. The hormonal variations of pregnancy and breastfeeding can alter the refraction, the corneal curvature and the quality of the tear film, making preoperative measurements unreliable and the final result unpredictable. It is recommended to wait at least 3 months after the end of breastfeeding before carrying out the preoperative assessment and the procedure.

The ranges generally accepted are: LASIK — short-sightedness up to -10 D, long-sightedness up to +5 D, astigmatism up to -5 D. PRK — short-sightedness up to -8 D, long-sightedness up to +4 D. SMILE — short-sightedness up to -10 D, astigmatism up to -5 D, long-sightedness up to +6 D with VISUMAX 800. Beyond this, the phakic implant takes over. The preoperative assessment adapts these ranges to the individual corneal thickness to ensure long-term safety.