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Wavefront-guided, or custom, laser eye surgery may be required if you have significant "higher-order" aberrations in your eye. These go beyond simple nearsightedness, farsightedness, and astigmatism, and can affect your vision even once these lower-order conditions have been treated.
Another group of people who require custom LASIK are patients who have had refractive surgery in the past, but are suffering from side effects or complications that keep them from achieving their best possible visual acuity.
If you are too nearsighted or farsighted, have too much astigmatism, or have thin corneas, you may not be a candidate for custom LASIK.