Abstract
BACKGROUND: The prevalence of myopia is increasing. Constant near-work, race, gender and genes are associated with development of myopia. Refractive laser surgery is eye surgey aimed at altering the refractive power of the cornea, and the procedures are among the most commonly performed in medicine. The main indication for refractive surgery of myopia is cosmetic; patients deem it a good alternative to wearing contact lenses and glasses.
PURPOSE: This paper gives an overview of the history of refractive surgery, the techniques used today and the results and complications arising from these.
METHOD: Literature study based on search in PubMed with ”LASIK”, ”PRK”, ”LASEK”, ”history”, ”overview”, ”epidemiology”, ”myopia” and ”complications” as search terms.
RESULTS: The most common surgical techiques used to correct myopia today are laser-assisted in-situ keratomileusis (LASIK) and photorefractive keratectomy (PRK). The excimer laser is applied to the surface of the cornea during PRK, while LASIK treatment involves creation of a hinged corneal flap and ablation of the underlying corneal stroma. PRK gives more postoperative discomfort and a slower visual recovery than LASIK. LASIK on the other hand involves a higher rate of severe intraoperative complications. The results for both methods are excellent, but severe complications can occur. The risk of negative outcome is low, but somewhat higher for LASIK.
INTERPRETATION: Given the risk of serious complications, healthy patients who wear glasses or contact lenses without discomfort could be better off by not undergoing laser surgery. If surgery is chosen as an option, PRK should be the preferred option due to lower risk of serious complications and negative outcome. Patients with high degree myopia should be told that the possibilies for good results are lower than for patients with low to moderate degree of myopia.