Ophthalmologist Questions Photorefractive Keratotomy (Prk) Eye Surgery

Is there an age restriction for a refractive surgery?

My daughter is 12 years old and has power glasses. Although she is used to the specs, she does find it irritating sometimes which affects her regularity of using them. I am not for lenses given her age. I wanted to understand if there is any age restriction for the refractive surgery. If yes, what is the best age I can get the same done for my daughter?

14 Answers

Thanks for your question. LASIK is only FDA approved in patients over 18 years of age. A patient's glasses prescription should be stable (not changing) for 2 years prior to having Lasik. I would not recommend Lasik on your 12-year old daughter.

You can learn more on the FDA website: https://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/SurgeryandLifeSupport/LASIK/default.htm
FDA approval for Laser Vision Correction surgery is 21. So 12 is too far from that to be evaluated. She should see an eye care professional regularly to get eye exams to measure her refractive state to see if there is any change. A good "Lasik" candidate needs a stable refraction in order to have a good target for laser treatment is she still desires this in the future. There are some new studies where patients with amblyopia can benefit from laser vision correction in order to help with visual development. It would be a good idea to see a pediatric ophthalmologist to check there refraction and look for any strabismus(crossed eyes).

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There are very good reasons why refractive surgery is not done on children your daughter’s age. The principal one is that her eyes have not completed their growth cycle and may require significantly different lens power in later years. For her to go through this major refractive surgical procedure upon the cornea of each eye and then have further growth and subsequent blurring vision from eyes that are no longer focused would be disturbing to her, her parents and her surgeon.

We typically prefer to not repeat the surgical procedure if it can be avoided as a distorted cornea can cause irregular astigmatism that is difficult to correct.

Roger Ohanesian MD
We only perform laser eye surgery on ages 18 and older. Two reasons for that:
1- one needs to be of legal age inorder to sign a medical consent form.
2- More likely than not that the prescription will continue to change till into the 20’s. Best to wait for the prescription to stabilize in the mid twenties before we laser the eyes.
Your daughter needs to be fully grown with a consistent refractive error for at least a year or two. In the early days, I used to do LASIK on 18-year-olds. Unfortunately, I found that too many of them went off to college and came back needing an enhancement a few years later. Now I don’t do surgery on anyone under 21 unless there are special circumstances and with full understanding that they may get a good result initially that could change over time.

Stephen M. Hamilton, MD
Refractive surgery cannot be done until the eye stops changing which is usually 18 for girls and 20 for boys. Contact lenses can be worn during the day or Ortho-K lenses can be worn at night.to flatten the eye and allow for good vision uncorrected during the day. LASIK is occasionally done for children but only as part of a study protocol and usually when only one eye needs treatment to treat or prevent amplyopia
There are some rules about the safe timing for surgery. The minimum age is 18-21, also the prescription should be stable for a year.
If she is a responsible girl, you may consider fitting contact lens with supervision for proper use.
Yes! In the United States, the FDA does not allow it for anyone under 21 years old. That would be my suggestion, too. In most countries, it is 21 years old as well, but there are a few that it is 18 years old.
The FDA approval age is 18 years old. There are various tests that need to be conducted to see if she qualifies for it and also a stable prescription for at least 2 years.
Earliest FDA approval for laser vision correction is 18, but that is for certain patients. 12 is too young.
Lasik is only for patients aged 18 and over, and best before aged 40 years
At 12 years old, your daughter's eyes are still developing. Since we don't know when her prescription will stabilize, it is not recommended to perform refractive surgery until the prescriptions have been stable for at least 2 years.
To answer your question, there is a minimum age requirement set forth by the FDA. That age is 18 years and up. At 12 years old, your daughter's eyes may still be changing and any surgery she would have today would likely change in the next few years. The surgery does not do anything to prevent the progression of myopia. Most individuals are stable by the time they are 18 years of age.
Refractive surgery, LASIK or PRK, is approved for 18 years and older. Most surgeons like to wait until at least age 21 AND evidence of a stable refraction (prescription) to ensure that the eyes have stopped growing.

In most cases, this applies to patients with myopia (near-sightedness). If she has hyperopia (far-sightedness), this can continue to increase for a longer time and so she might not be a candidate even after she is fully grown because the refraction is not stable.

Exceptions are made in children for when one eye is much weaker than the other and is at risk for losing vision (amblyopia). This is typically done at an academic center after careful consultation and review by pediatric ophthalmologists if all other options have been exhausted.