Laser eye surgery sounds tempting: a life without glasses or contact lenses, clear vision from the moment you wake up until you go to sleep. But when is the right time to take this step? Many people ask themselves whether they are too young or perhaps already too old for laser vision correction. In this blog, you will find out at what age laser eye surgery makes sense, why the years between 20 and 40 are particularly ideal and what options are available if “conventional” laser eye surgery is no longer ideal later in life. Whether you are struggling with short-sightedness, long-sightedness, astigmatism, cataracts or presbyopia – you will find all the answers you need to make your decision here.

Minimum age for laser vision correction: When is the procedure possible?

The minimum age for laser eye correction is 18 years. Laser treatment can only be carried out from this age in most cases. The reason for this is that the eye continues to develop until adulthood and visual acuity only stabilizes after this phase. However, age is not the only factor – other important requirements must also be met for laser eye treatment to be successful.

Why is the minimum age for laser eye surgery 18?

The reason why the minimum age for laser vision correction is 18 is because the eye matures. Before this age, the eye is still changing considerably, especially the refractive power of the eye, which affects visual acuity. During adolescence, the eyeball and cornea grow, which often leads to fluctuations in visual impairment such as short-sightedness or long-sightedness. It is only from the age of around 18 that the visual acuity of most people has stabilized, i.e. the dioptre values remain constant over a longer period of time. Stable vision is crucial, as laser vision correction only makes sense if the visual defect does not deteriorate further. If the eye were still growing, visual defects could reappear after the laser treatment, which would render the procedure ineffective. It is therefore advisable to consider laser eye treatment from the age of 18 at the earliest.

Stable vision: why it is so important

Stable vision is when the diopter values of the eye have not changed over a period of at least twelve months. This means that neither short-sightedness, long-sightedness nor any astigmatism has increased. This stability is a key prerequisite for successful laser vision correction, as it ensures that the results of the treatment will be maintained in the long term.

What happens if the requirements for laser eye surgery are not met?

If the requirements for laser eye surgery, such as stable vision or a healthy cornea, are not met, the procedure is unfortunately not possible. There are various reasons why laser vision correction is not an option. These so-called contraindications should be taken into account in order to avoid the risk of undesirable side effects or incomplete correction.

Possible contraindications for laser eye surgery:

• Unstable visual acuity: If the visual acuity continues to change, e.g. due to a growing eye or progressive defective vision, laser treatment is not advisable.
• Diopters too high: In the case of very severe short-sightedness (more than -10 diopters) or long-sightedness (more than +4 diopters), the cornea may be too thin to be lasered safely.
• Corneal problems: A cornea that is too thin or irregular (e.g. keratoconus) poses a considerable risk as it is not sufficiently stable for laser treatment.
• Dry eyes: Patients with chronically dry eyes have an increased risk of postoperative complaints, which is why laser eye correction is often not recommended in this case.
• Presbyopia (presbyopia): From around the age of 45, the lens loses its flexibility, which means that laser treatment alone is often no longer sufficient to fully correct vision.
• Eye diseases: Diseases such as cataracts or glaucoma are also exclusion criteria for laser eye treatment, as they affect deeper structures of the eye.

Lens surgery as an alternative for high diopters and presbyopia

If laser eye surgery is no longer possible due to excessive diopters or advanced presbyopia, lens surgery can be a sensible alternative. Special artificial lenses are inserted into the eye, which take over the function of the natural lens and correct the visual impairment.

• ICL (implantable contact lens): This method is often used for patients whose visual defect (e.g. short-sightedness of -10 diopters or more) is too severe to be corrected by laser eye treatment. A thin lens is inserted into the eye without removing the natural lens.
• Lens exchange (refractive lens exchange): This option is particularly useful for presbyopia or cataracts. The natural lens is replaced with a multifocal artificial lens, which improves both near and distance vision. This method is also a long-term solution for cataracts, which often occur at an advanced age.

Maximum age: Until when does laser eye surgery make sense?

Although there is no set maximum age for laser eye treatment, the procedure is often no longer the optimal solution at an advanced age. This is mainly due to age-related changes in the eye, which can occur from around the age of 45. One of the most common changes is presbyopia, in which the lens loses flexibility and near vision becomes increasingly difficult. Eye diseases such as cataracts or glaucoma also occur more frequently with increasing age and influence the suitability for laser eye treatment.

Contraindications for laser eye surgery: Presbyopia (presbyopia) & cataracts

• Presbyopia(presbyopia): From the age of around 45, the natural lens loses its elasticity. This makes it difficult to see near objects clearly. Pure laser treatment, such as LASIK or Femto-LASIK, can correct the defective vision for distance vision, but cannot eliminate the problems with near vision. This means that glasses are often required for near vision.
• Cataracts: Cataracts mainly affect people over the age of 60 and lead to a clouding of the natural lens. In such cases, laser eye surgery no longer makes sense, as the clouding cannot be removed by the laser. Instead, lens replacement is recommended.
• Corneal changes: The cornea can also change with age, making it thinner or less flexible. This can impair or even prevent the success of laser vision correction.

Alternatives to laser eye treatment at an advanced age

For presbyopia PresbyMAX laser eye treatment comes into play. This innovative treatment method was specially developed to correct presbyopia. PresbyMAX is a laser-based procedure that reshapes the cornea so that it is optimally adapted for both near and distance vision. The targeted alteration of the cornea improves visual acuity at various distances. The great advantage of this method is that patients can get by again without glasses or contact lenses in everyday life – both when reading and when looking into the distance. PresbyMAX is particularly suitable for people aged 45 and over who do not want to use additional glasses for near vision. It can also be combined with other laser treatments such as LASIK to correct existing visual defects at the same time.

Lens exchange as an alternative: a solution for presbyopia and cataracts

If presbyopia or other age-related changes, such as cataracts, continue to progress, refractive lens exchange (RLE) can offer a permanent solution. This involves removing the eye’s natural lens and replacing it with an artificial lens. These artificial lenses, often multifocal or trifocal, are designed to improve both near and distance vision.

Refractive lens exchange (RLE) for presbyopia

In refractive lens replacement, the hardened, inflexible lens is replaced with a multifocal artificial lens. This artificial lens enables the eye to see both near and distant objects clearly, eliminating the need for reading glasses. Lens replacement is particularly suitable for people who are no longer suitable candidates for laser eye surgery such as LASIK or PresbyMAX due to their age.

Lens replacement for cataracts

Lens replacement is also the standard treatment for cataracts. In cataracts, the natural lens of the eye becomes cloudy, leading to blurred vision. Lens replacement removes this clouding and restores full visual acuity. The cloudy lens is removed and replaced with a clear artificial lens, which can also correct visual defects such as short-sightedness, long-sightedness or even astigmatism.

The ideal age: when you are suitable for laser vision correction

The ideal age for laser eye treatment is between 20 and 40. The best conditions are met at this stage of life: vision is stable and the risk of age-related changes is still low. Nevertheless, there may also be sensible alternatives to laser eye treatment for people aged 45 and over, such as lens replacement or other procedures specifically aimed at correcting presbyopia. In order to find the best individual solution, a thorough preliminary examination by an ophthalmologist is essential. This will determine whether laser eye surgery makes sense or whether other treatment methods are more suitable.