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There are several conditions which make it impossible for a patient to receive the benefits of custom LASIK.
Because the custom surgery can involve removing more tissue than standard LASIK, patients with thin corneas may not be eligible for wavefront-guided LASIK surgery. In addition, those with strong nearsightedness, farsightedness, or astigmatism, as well as those with especially large pupils, may be discouraged from having this surgery.
If you are seeking monovision treatment for presbyopia, you will be better off with standard LASIK treatment, since current lasers cannot perform the undercorrection required for proper monovision.
If you have few higher-order aberrations and meet the other guidelines for refractive surgery candidates, the benefit of custom LASIK may not be worth the cost for you. You may wish to get more than one eye surgeon's opinion before making this choice.