Refractive surgery: what patients need to know

OBJECTIVE: Most procedures to treat refractive error are based on laser surgery, but other techniques are available. We review the relative advantages and the risk associated with the different surgical options. AREAS OF AGREEMENT: Laser refractive surgery is now a safe and effective alternative to glasses or contact lenses. AREAS OF CONTROVERSY: Because refractive surgery is an area of rapidly developing technology, the relative benefits of the different surgical options remain uncertain. AREAS TO DEVELOP RESEARCH: Controlled trials are needed to provide better guidance as to the relative merits of the different surgical options. Better interventions are required to minimize the biological response after laser surface treatment to eliminate the need for mechanical cutting of a flap for laser in situ keratomileusis. An effective surgical treatment for presbyopia is awaited.