When LASIK Isn't Right For You: Key Contraindications and Alternatives

Clinical Considerations for LASIK Eligibility

LASIK is not appropriate for every individual. Patients with conditions such as keratoconus, or advanced dry eye typically are not candidates for LASIK. Similarly, while PRK can be considered in some cases, these same contraindications often apply. Candidacy for either procedure depends on maintaining healthy corneas and managing any underlying health issues. If surgical vision correction is not recommended, your eye care provider can offer non-surgical options such as prescription eyewear or contact lenses. At Rochester Eye & Laser Center, our specialists provide comprehensive, no-cost consultations to determine your eligibility and tailor recommendations to your unique needs.

If you are considering LASIK but have questions about your health or suitability, the Rochester Eye & Laser Center team offers decades of experience in laser vision correction. Our exclusive focus on LASIK and PRK means we deliver in-depth evaluations with precision and safety as top priorities. Certain conditions—including keratoconus, glaucoma, and significant dry eye—often mean that LASIK or PRK are not advisable due to heightened risk. However, if you are not a suitable surgical candidate, we will guide you toward non-surgical solutions that best support your visual health. The information below outlines common LASIK contraindications, key eligibility standards, and how our expert team ensures your care path aligns with recognized safety and performance standards.

Common LASIK Contraindications

LASIK and PRK reshape the cornea to correct vision, but certain conditions make these procedures risky or ineffective. Below are key contraindications:

Keratoconus: Corneal thinning and bulging destabilize the cornea, making LASIK or PRK unsafe.
Retinal Problems: Conditions like retinal detachment or macular degeneration heighten surgical risks.
Herpes Simplex Eye Disease: HSV in the eye can reactivate during surgery causing complications if someone has HSV or dendrites in the cornea, not if they have had a cold sore on their lip in the past and no eye involvement.
Severe Dry Eye: Chronic dry eye, unrelieved by treatment, complicates recovery.
Autoimmune Diseases: Conditions like uncontrolled Rheumatoid arthritis, MS, Lupus, Autoimmune Disorder, Fibromyalgia, can impair healing.
Diabetic Retinopathy: Poorly managed diabetes affects corneal healing.
Pregnancy or Nursing: Hormonal changes cause unstable vision prescriptions.
Eye Injuries or Trauma: Certain eye injuries can also damage the retina, the part of the eye responsible for sending visual signals to the brain. If the retina is scarred, torn, or detached, it can lead to permanent vision loss and usually makes a patient ineligible for LASIK or PRK.

Eligibility for LASIK or PRK

LASIK and PRK candidacy require specific eye and health conditions to ensure safety and effectiveness.

Rochester Eye Eye and Laser Center evaluates:

Corneal Health - Corneas must be healthy, with adequate thickness and no scarring or thinning.
Eye Health - No active conditions like severe dry eye or retinal issues.
General Health - No uncontrolled conditions that impair healing.
Dry Eye Control - Dry eye must be well-managed to support surgical recovery.

ASA: A Targeted Alternative for Select LASIK Contraindications

Advanced Surface Ablation (ASA)
provides a precise, technically advanced solution for individuals who are not candidates for LASIK, particularly when corneal thickness or previous injuries make flap creation inadvisable. By reshaping only the surface layer of the cornea, ASA mitigates flap-related risks and is well suited for patients with marginally thin corneas or superficial scarring. However, contraindications such as keratoconus or pronounced dry eye can also exclude ASA as an option.

At Rochester Eye & Laser Center, we take a highly personalized approach to determining ASA eligibility. Our ophthalmic specialists perform comprehensive assessments—including corneal stability analysis, full ocular health history, and individualized healing profiles—to ensure ASA delivers both safety and optimal vision outcomes tailored to your specific needs.

Alternatives to LASIK and ASA

If neither LASIK nor ASA is recommended based on your individual health profile, Rochester Eye & Laser Center remains committed to delivering safe, effective vision correction solutions. Our team will work with you to assess the full spectrum of non-surgical options, including precision prescription eyewear and advanced contact lens technologies, ensuring your visual needs are addressed with the same attention to safety, technical excellence, and personalized care. Should specialist evaluation be required, we will connect you with trusted providers to support your long-term eye health and visual performance.

Managing Dry Eye with Clinical Precision

Severe dry eye is a significant factor when assessing candidacy for LASIK or ASA, and its management is essential for safe surgical outcomes or successful non-surgical vision correction. At Rochester Eye & Laser Center, we employ a comprehensive, evidence-based approach to address dry eye, utilizing advanced therapies and tailored patient care.

Common strategies include:

- Preservative-free artificial tears to sustain ocular surface hydration and comfort

- Punctal plugs, engineered to optimize tear retention and reduce evaporation

- Prescription anti-inflammatory eye drops, such as cyclosporine, to promote healthy tear production

- Lifestyle adjustments—including limiting screen exposure and optimizing humidification—to support long-term ocular wellness

These interventions are customized by our experienced clinical team to maximize corneal health and visual performance, empowering you with durable, safe solutions for your unique eye care needs.

Why Contraindications Matter

Contraindications protect your eye health by preventing complications like:

Corneal Instability: Conditions like keratoconus can worsen with corneal surgery.
Poor Healing: Uncontrolled autoimmune diseases or diabetes may delay or impair recovery.
Vision Complications: Retinal or glaucoma issues increase risks of vision loss post-surgery.
Dry Eye Worsening: Severe dry eye can exacerbate post-surgical discomfort or complications.

We prioritize safety, ensuring only suitable candidates proceed with LASIK or ASA.

How Rochester Eye and Laser Center Evaluates for LASIK and ASA

During your free consultation, expect:

Health History Review: Assessment of eye conditions, systemic diseases, or medications affecting candidacy.
Corneal Evaluation: Advanced tools like corneal topography check thickness, scarring, or irregularities.
Eye Health Exam: Diagnostics screen for dry eye, retinal issues, or other contraindications.
Vision Discussion: Exploration of your goals to assess LASIK or PRK candidacy or recommend referral to your eye care team.

Take the Next Step Toward Clear Vision

Concerned about LASIK contraindications? Schedule a free consultation with the Rochester Eye and Laser Center, or take our online LASIK Self Evaluation to see if you are a good candidate for a consultation. Our team is here to assess your suitability for LASIK or ASA, or guide you to clearly better vision with other alternatives.