Refractive surgery: the future of perfect vision?

The history of refractive eye surgery is recent, but has seen rapid advancement. Older technologies, such as radial keratectomy, had the problem of overcorrection and epithelial complications. Newer technologies, such as photorefractive keratectomy, laser-assisted in-situ keratomileusis (LASIK) and laser-assisted subepithelial keratomileusis (LASEK), which require the use of laser, has revolutionised eye surgery. However, there are complications, such as corneal hazing, postoperative pain, regression, and poorer correction for high myopes. If not contraindicated, wavefront analysis and femtosecond laser are useful adjuncts to laser photoablation for better visual results. Wavefront analysis improves the precision of laser photoablation by measuring the individual's wavefront aberrations, while femtosecond laser offers an instrument-free means of creating the corneal hinge. Lastly, implantation of intraocular lenses, with or without extraction of the crystalline lens, provides an alternative to laser photoablation for the treatment of high myopia. Clear lens exchange offers refractive correction to presbyopes and people with cataracts. However, complications, such as endothelial cell loss, cataract formation and retinal detachment, exist. In conclusion, refractive eye surgery provides an alternative to wearing spectacles or contact lenses. However, potential patients must be warned of the complications and long-term effects on the eyes.