From What Age to What Age Is LASIK Possible? What Matters More Than Age?

 

The minimum age for LASIK is 18, and no upper age limit is specified in the guidelines reviewed [1][4]. However, turning 18 is only the starting point. The actual criterion is whether your myopia and astigmatism prescription has remained stable over the past year [1][2].

The Korea Disease Control and Prevention Agency (KDCA) states that candidates should be at least 18 years old and have had no changes in their refractive error over the previous year. It also advises against surgery if the prescription continues to change even after age 18 [1]. At the upper end, the American Academy of Ophthalmology (AAO) does not list an upper age limit among its contraindications. Instead, from the 40s onward, presbyopia, dry eye, and cataracts can affect the outcome [4][13].

A question like this appears on Naver Knowledge iN:

“I’ve worn glasses for a long time and am considering SMILE LASIK. I’m wondering if there are any age requirements. Is it generally recommended to consider vision correction surgery after growth is complete and vision has stabilized? If my myopia prescription is still changing, should I postpone surgery?”

Why Is Prescription Stability More Important Than Simply Being 18?

The reason prescription stability matters is that if the eye’s prescription is still changing, the correction achieved through surgery may no longer be accurate over time [1][4]. The U.S. Food and Drug Administration (FDA) states that no LASIK laser has been approved for use in people under 18. It also identifies people who have needed a change in their glasses or contact lens prescription within the past year as unsuitable candidates [2].

The AAO guidelines classify unstable refraction—a condition in which the prescription continues to change—as a contraindication. They also consider being under 21 a relative contraindication and recommend checking the FDA-approved labeling for each laser system [4]. The AAO’s patient information similarly states that candidates should be at least 18, preferably 21 or older, and should not have experienced significant prescription changes during the previous year [3].

Criteria	Korea Disease Control and Prevention Agency (KDCA) [1]	U.S. FDA [2]	American Academy of Ophthalmology (AAO) Guidelines [4]
Age	18 or older	No approved LASIK lasers for those under 18	Under 21 is a relative contraindication; check the labeling for each laser
Prescription stability	No refractive changes over the past year	A prescription change within the past year may make someone an unsuitable candidate	Unstable refraction is a contraindication
Upper age limit	Not specified	Not specified	Not listed among contraindications

Does Myopia Stop Progressing Once You Finish Growing?

Myopia does not necessarily stop progressing once physical growth is complete [6][7]. In the U.S. COMET study, which followed 426 children with myopia for 11 years, the average age at which myopia stabilized was 15.6 years. However, the standard deviation was 4.2 years, meaning that a considerable number of people continued to experience changes into their 20s [5].

A study based on optometry records in Ireland examined 18,620 people with myopia aged 18–39. It found that 10.7% experienced progression of more than 0.25 diopters per year [6]. The rate was 19.9% among those aged 18–24, compared with 6.8% among those aged 40–44. In other words, the rate in the youngest group was approximately three times higher [6].

In an Indian study comparing the previous year's glasses prescriptions with current prescriptions in 2,683 people with myopia aged 18–30, 12.7% experienced progression of more than 0.5 diopters over one year, while 4.6% worsened by more than 1 diopter [7]. People aged 18–20 were 1.63 times more likely to experience progression, while eyes with higher astigmatism had 6.6 times the likelihood [7].

In South Korea, the age groups most likely to seek LASIK are also those with the highest prevalence of myopia [1]. According to the 2021 Korea National Health and Nutrition Examination Survey, the prevalence of myopia among people aged 19–29 was 73.4%. An earlier survey conducted between 2008 and 2011 found that prevalence decreased substantially with age, from 78.9% among people in their 20s to 16.1% among those in their 60s [1][8].

What If Astigmatism Continues to Worsen at Age 27?

If astigmatism continues to increase in adulthood, the underlying cause should be investigated before deciding when to undergo LASIK [9]. The KDCA states that increasing astigmatism during adolescence or adulthood may indicate keratoconus, a condition in which the cornea thins and bulges outward into a cone-like shape. A thorough examination is therefore recommended [9].

If keratoconus is suspected, the patient is generally not a candidate for corneal reshaping surgery, regardless of age [1][4]. Corneal thickness and the risk of corneal ectasia are discussed in the LASIK vs. LASEK article.

Prescription stability can be assessed by comparing refraction records taken approximately one year apart [1][4]. In people who have worn hard contact lenses or soft toric lenses for astigmatism, corneal shape changes may persist for longer. The guidelines therefore note that multiple visits may be needed to confirm stability [4].

Does Being Older Mean You Cannot Have LASIK?

There is no upper age limit for LASIK, and outcomes have been reported in patients in their 40s, 50s, and 60s [4][10]. However, older patients have generally experienced slightly lower effectiveness and higher enhancement rates, meaning they were more likely to need additional surgery [10][11][12].

A U.S. study analyzing 710 eyes in 424 patients aged 40–69 found that 81–90% achieved a result within ±1 diopter of the target prescription. No eyes lost more than two lines of corrected visual acuity, while 1.3% lost two lines [10]. Older patients tended to have higher enhancement rates and a greater tendency toward undercorrection of myopia [10].

Study	Comparison	Results	Reference
U.S. study of 710 eyes in patients aged 40–69	Patients in their 40s, 50s, and 60s	81–90% within ±1 diopter; 1.3% lost two lines of corrected visual acuity	Ghanem et al. [10]
Matched analysis of 64,970 cases in Israel	Patients aged 60 or older vs. those aged 20–40	Similar safety, lower effectiveness, and more enhancements in the older group	Hecht et al. [11]
German study of 288 eyes undergoing lenticule extraction	Patients aged 55 or older vs. those aged 35 or younger	20/20 vision achieved in 79% vs. 93%; enhancement rates of 9% vs. 1%	Neuhann et al. [12]

The same general pattern was observed with SMILE-type procedures, which involve removing a small piece of tissue from inside the cornea, a technique known as lenticule extraction [12]. In a German multicenter study, 76% of patients aged 55 or older achieved a result within ±0.5 diopters, compared with 88% of those aged 35 or younger. However, more than 95% of both groups achieved results within ±1 diopter [12].

Why Do People Say LASIK Is Not Suitable After Age 40?

The main reason LASIK may be unsuitable after age 40 is not age itself, but presbyopia [13]. In a study of 648 people undergoing LASIK screening in the United States, 69.4% were found to be unsuitable candidates. Among patients aged 45 or older, presbyopia was the leading reason for exclusion [13].

The reasons for exclusion were different among people younger than 45 [13]. The most common were abnormal corneal topography (43.5%), thin corneas (24.5%), and high myopia (20.7%).

In this study, younger patients were more often excluded because of corneal problems, while older patients were more often excluded because of presbyopia [13]. Even if someone has presbyopia, correcting myopia can still improve distance vision. However, other considerations remain after surgery [3].

What Changes When You Have LASIK After Age 40?

After age 40, several factors become more important when considering LASIK, including near vision, dry eye, and the risk of damage to the corneal surface during surgery [3][16][18]. The AAO guidelines recommend that patients be informed about dry eye and the eventual development of presbyopia as part of the preoperative consent process [4].

Will LASIK Make Me Need Reading Glasses Sooner?

LASIK does not correct presbyopia. As a result, people who can see clearly at a distance may begin needing reading glasses around age 40 [3]. The KDCA states that presbyopia typically begins in the early 40s and progresses into the 60s [14].

People with myopia may be able to see nearby objects clearly without glasses, so they may not need reading glasses as early [9]. When LASIK corrects their distance vision, this advantage may disappear [9].

The FDA also notes that people who used reading glasses before surgery may still need them afterward [2].

A Japanese study compared LASIK outcomes in 53 eyes of 40 patients aged 45 or older with high myopia. The average reading-glass prescription increased from 1.80 diopters before surgery to 2.18 diopters three months afterward [15]. In 60.4% of eyes, patients needed an additional 0.5 diopters or more of reading-glass power. This change was more pronounced in younger patients with early presbyopia [15].

The KDCA recommends measuring near vision during preoperative examinations for patients aged 40 or older [1]. Options for managing presbyopia, such as monovision—which corrects one eye for near vision—are discussed in the presbyopia surgery options article.

Does Dry Eye Become More Common With Age?

The risk of dry eye after LASIK increases with age [16]. A study in Israel analyzing 25,317 eyes that underwent myopic LASIK or PRK found clinically significant dry eye in 1,518 eyes. Each additional year of age was associated with a 1.3% increase in risk [16].

The same study identified female sex, lower refractive error, and LASIK (compared with PRK) as additional risk factors [16]. The KDCA notes that dry eye becomes more common after age 40 and that vision correction surgery can reduce tear secretion by temporarily diminishing corneal sensitivity [17].

In the FDA's PROWL studies, approximately 35% of patients reported dry eye symptoms three months after LASIK. Around 25% of those who had no dry eye symptoms before surgery reported new symptoms afterward [4]. The guidelines classify uncontrolled dry eye as a contraindication and inadequately controlled dry eye as a relative contraindication [4].

Does Corneal Healing Slow Down With Age?

Epithelial defects, in which the surface layer of the cornea is damaged during surgery, were almost three times as common in patients over 40 [18]. In a study of 6,984 LASIK procedures at Emory University in the United States, epithelial defects occurred in 4.1% of patients under 40 and 13.2% of those over 40. Multivariable analysis found that patients over 40 had a 2.7-fold higher risk [18].

If I Have Cataracts, What Can I Consider Instead of LASIK?

If cataracts affect vision, cataract surgery—not LASIK—is generally the appropriate surgical option for correcting the problem [4]. The AAO guidelines list visually significant cataracts as a contraindication to LASIK and recommend checking for early cataracts when there is substantial lenticular astigmatism, meaning astigmatism originating from the natural lens [4].

In such cases, surgery involving the natural lens may be a better option than reshaping the cornea [4]. The KDCA also excludes eyes with cataracts from refractive surgery candidacy [1].

A question like this appears on Naver Knowledge iN:

“I’m 51 and have presbyopia and astigmatism. Can I have LASIK?”

Being 51 is not, in itself, a contraindication to LASIK [4]. However, LASIK does not treat presbyopia, and whether cataracts are present can determine which type of surgery is more appropriate [3][4].

The criteria for deciding when cataract surgery is needed are discussed in the cataract surgery timing article. The primary indication for cataract surgery is whether vision has deteriorated enough to interfere with everyday activities, rather than the patient's age [19].

Can I Have Cataract Surgery Later If I Have Already Had LASIK?

Cataract surgery is still possible after LASIK, but calculating the correct power of the artificial intraocular lens (IOL) becomes less accurate [19]. The AAO's cataract guidelines state that previous LASIK or PRK does not necessarily make the surgery itself more difficult, but IOL power calculations are less accurate than in eyes that have not undergone refractive surgery [19].

For this reason, LASIK guidelines recommend giving patients their preoperative corneal curvature and refraction measurements, along with their postoperative refraction records, and advising them to keep these records for future reference [4].

Data from the Bascom Palmer Eye Institute in the United States found that patients with a history of LASIK underwent cataract surgery at an average age of 64, compared with 73 among those without a history of LASIK [20]. This study identified an association; it does not prove that LASIK causes cataracts to develop earlier [20].

What Should I Check During a Consultation?

1. Bring refraction records covering at least the past year and confirm whether your prescription has remained stable, within 0.5 diopters [1][4].

2. If your astigmatism is increasing, undergo corneal topography to check for keratoconus before considering surgery [9].

3. If you are 40 or older, have your near vision measured and ask when you might need reading glasses after surgery [1][2].

4. Review your tear test results and check for dry eye. If dry eye is present, discuss treatment and reassess your suitability for surgery afterward [1][4].

5. Have a slit-lamp examination—a routine examination that magnifies the eye under a microscope—to check for early cataracts [4].

6. Obtain and keep your preoperative corneal curvature and refraction records [4].

Rather than your age alone, the answers to these six questions help determine whether your eyes are suitable for LASIK [1][4]. To find out which category applies to you, consult an ophthalmologist and undergo a comprehensive eye examination.

Sources 

1. Korea Disease Control and Prevention Agency (KDCA). Refractive Surgery for Myopia.

2. U.S. Food and Drug Administration. When Is LASIK Not for Me?

3. Hura AS (reviewed). LASIK — Laser Eye Surgery. American Academy of Ophthalmology. January 9, 2026.

4. American Academy of Ophthalmology. Refractive Surgery Preferred Practice Pattern (2022, updated 2024). Ophthalmology. 2023;130(3)–P135.

5. COMET Group. Myopia Stabilization and Associated Factors Among Participants in the Correction of Myopia Evaluation Trial (COMET). Investigative Ophthalmology & Visual Science. 2013;54(13):7871–7884.

6. Moore M, Lingham G, Flitcroft DI, Loughman J. Patterns of Myopia Progression in European Adults. Ophthalmology Science. 2025;5(3):100713.

7. Manoharan MK, Tivari UP, Reddy JC, Verkicharla PK. Myopia Progression in Young Adults: Insights From Real-World Clinical Data. Clinical and Experimental Optometry. 2025;108(7):873–879.

8. Kim EC, Morgan IG, Kakizaki H, Kang S, Jee D. Prevalence and Risk Factors for Refractive Errors: Korean National Health and Nutrition Examination Survey 2008–2011. PLOS ONE. 2013;8(11).

9. Korea Disease Control and Prevention Agency (KDCA). Refractive Errors (Myopia, Hyperopia, and Astigmatism).

10. Ghanem RC, de la Cruz J, Tobaigy FM, Ang LP, Azar DT. LASIK in the Presbyopic Age Group: Safety, Efficacy, and Predictability in 40- to 69-Year-Old Patients. Ophthalmology. 2007;114(7):1303–1310.

11. Hecht I, Achiron A, Ben Haim L, Sorin V, Mimouni M, Kaiserman I. Refractive Surgery in the Late Adulthood and Adolescent Age Groups. Graefe’s Archive for Clinical and Experimental Ophthalmology. 2019;257(9):2057–2063.

12. Neuhann L, Javadi A, Kassumeh S, et al. Outcomes of Keratorefractive Lenticule Extraction in Older Adults: A Multicenter Analysis. Journal of Refractive Surgery. 2026;42(9)–e941.

13. Jaafar M, Han KD, Sitto MM, et al. Evaluating the Rate and Causes of Non-Candidacy After Laser-Assisted in Situ Keratomileusis (LASIK) Screening. Cureus. 2025;17(6).

14. Korea Disease Control and Prevention Agency (KDCA). Presbyopia.

15. Tsuneyoshi Y, Negishi K, Saiki M, Toda I, Tsubota K. Apparent Progression of Presbyopia After Laser in Situ Keratomileusis in Patients With Early Presbyopia. American Journal of Ophthalmology. 2014;158(2):286–292.

16. Shehadeh-Mashor R, Mimouni M, Shapira Y, Sela T, Munzer G, Kaiserman I. Risk Factors for Dry Eye After Refractive Surgery. Cornea. 2019;38(12):1495–1499.

17. Korea Disease Control and Prevention Agency (KDCA). Dry Eye Disease.

18. Randleman JB, Lynn MJ, Banning CS, Stulting RD. Risk Factors for Epithelial Defect Formation During Laser in Situ Keratomileusis. Journal of Cataract and Refractive Surgery. 2007;33(10):1738–1743.

19. American Academy of Ophthalmology. Cataract in the Adult Eye Preferred Practice Pattern (2021). Ophthalmology. 2022;129(1)–P126.

20. Yesilirmak N, Chhadva P, Diakonis VF, Waren DP, Yoo SH, Donaldson KE. The Effect of LASIK on Timing of Cataract Surgery. Journal of Refractive Surgery. 2016;32(5):306–310.

This article provides general information based on publicly available materials from the Korea Disease Control and Prevention Agency, the U.S. FDA, the American Academy of Ophthalmology, and peer-reviewed scientific literature. It does not recommend a specific medical institution or replace a professional diagnosis. An ophthalmologist's examination is necessary to determine whether LASIK is suitable for your eyes.