The analysis of 56 successive procedures for correction of severe myopia enables us to determine the indications of the two surgical techniques we use: Myopic keratomileusis or Myopic Epikeratophakia. The results are very different. They are reliable and steady throughout one year for certain myopias, but more uncertain for more severe ones. This led us to distinguish two subgroups: the first includes the initial myopia equal to or less than -15 dioptres, the second includes the more severe myopia. Epikeratophakia, always implemented using fresh lenticules corrects more severe myopias than keratomileusis (from -15 to -30 dioptres). So, the indication for epikeratophakia depends on the initial ametropia, as well as on refractive parameters such as keratometry. With the same myopia, an anterior curvature radius over 8.2 mm will render a myopic keratomileusis less efficient then a myopic epikeratophakia. The results with one year follow up are more predictable and stable for the first subgroup. The second group and those cases corrected by epikeratophakia had less predictable results.