A variable applanation patient interface can include a lens support system attachable to a distal end of an ophthalmic surgical laser system； a contact lens supported by the lens support system and configured to make contact with an eye surface； and an adjustable coupler coupled to at least one of the lens support system and the contact lens and configured to be coupled to a non central region of the eye surface to accommodate the contact lens to contact a central region of the eye surface with a central applanation to enable a change between the central applanation and an extended applanation and to accommodate the contact lens to contact an extended region of the eye surface larger than the central region with the extended applanation.
