Individualized myopia surgery includes optimal cutting patterns, Q-adjusted cutting, corneal topography-guided cutting, wavefront aberration-guided cutting, etc. In order to better develop an individualized surgical plan, it is recommended that a comprehensive consideration of the patient’s background related to his or her professional life should be performed before surgery. The goal is to eliminate the refractive error without altering the current coordination of the eye, and ultimately to obtain clearer, more comfortable, and longer lasting vision. The human eye is not a perfect refractive system, and the presence of aberrations in the human eye prevents the human eye from making full use of retinal resolution (photoreceptance). However, over the course of evolution, the refractive components of the human eye have compensated for each other and, through feedback to the cerebral cortex, have created a unique refractive system for the human eye. It is not perfect, but it is coordinated and uniform. Therefore, what refractive surgery does is not to create a perfect refractive system, but rather to eliminate some of the imperfections without changing the coordination of the eye itself. This harmonization is unique to the genetic and life circumstances of the surgical subject, and therefore requires that the concept of individualization be emphasized in every detail of the refractive surgery design. Principles to be followed in surgical design It is important to emphasize that different individualized cutting surgical approaches have their own target population. For some populations, a traditional model of cutting combined with an appropriate surgical design is more appropriate. As a simple example, what type of surgery should be used to correct myopia in patients over 40 years of age? The following points should be considered when selecting a surgical treatment plan: First of all, this group of patients has common characteristics such as a high level of near eye use, the possible presence of old light or cataracts, and an increased need for adjustment after refractive surgery. Therefore, a thorough evaluation of the lens and accommodation must be performed prior to surgery. The surgical design follows three principles: the principle of optimal correction, the principle of reasonable undercorrection, and the principle of binocular balance. For subjects with lens clouding, either conventional excimer laser surgery or cataract surgery combined with adjustable IOL implantation is an option. Excimer laser surgery can be selected according to the patient’s adjustment ability and eye habits for optimal correction, reasonable undercorrection or monocular vision; the cutting mode can be selected according to the characteristics of the patient’s refractive system for different guidance modes. Nowadays, the concept of “individualization” of keratomileusis is increasingly focused on wavefront aberration-guided surgery. Excimer laser cutting is not fully individualized in the sense. However, wavefront aberrations are becoming more refined and individualized. As mentioned at the beginning of this article, not all higher order aberrations need or should be uniformly corrected in keratoconus. There are now some excimer devices that are already making such attempts. For example, SCHWIND Germany has equipped the AMARIS excimer laser system with the most complete and accurate wavefront aberration diagnostic platform, which accurately and comprehensively analyzes the whole-eye wavefront aberration and corneal wavefront aberration data of the human eye, and with the help of SCHWIND CAM surgical design software, provides two online personalized correction plans for the surgeon’s selection to maximize each patient’s The post-operative result is perfect for each patient. These details will also be further described in future lectures.