Laser refractive eye surgery

Summary points

• Refractive errors are common

• Laser eye surgery is an effective alternative to refractive correction with spectacles or contact lenses

• Glasses do not cause long term corneal problems, but contact lenses carry a small risk

• Serious complications of laser eye surgery are rare and can be minimised through patient selection and advances in technology

• Less serious complications are common and often under-reported as “side effects” or “symptoms”

• Data on long term safety and stability are lacking largely because techniques are still evolving

Sources and selection criteria

We searched PubMed for articles in English on laser refractive surgery. We also consulted guidelines issued by the Royal College of Ophthalmologists, the American Academy of Ophthalmologists, and the National Institute for Health and Clinical Excellence. We identified systematic reviews and randomised controlled trials as well as informative and relevant level C research. Search terms were “laser assisted in situ keratomileusis”, “laser epithelial keratomileusis”, “photoreactive keratotomy”, “myopia”, “hyperopia”, “astigmatism”, and “laser surgery”.