Safety and suitability are not the same.
A patient may be technically safe for laser eye surgery but unsuitable for achieving durable, long-term benefit. Examples include early presbyopia, unstable refraction, shallow anterior chambers, or expectations that cannot be met by corneal reshaping alone.
Ethical refractive practice prioritises long-term visual outcomes over short-term correction. In some cases, recommending against laser treatment best protects the patient’s future vision.
When surgery is declined, it is good practice to explain alternatives clearly and document the rationale openly. Saying “no” is not a failure of care; it is often a marker of sound clinical judgement.
References
- Almutairi MN, Alshehri AM, Alhoumaily AY, et al. Clinical outcomes of LASIK and PRK in hyperopia: a meta-analysis. BMC Ophthalmology. 2025;25:140.
- Packer M. Phakic intraocular lenses: a review. Clinical Ophthalmology. 2016;10:1059–1076.
