A Look At Refractive Surgeries.

Refractive surgery has been a hot debate over the past seventeen years, since radial
keratotomy (RK) was brought to this country by Bores in 1977 [ 1 ]. As a growing number
of ophthalmologists offer this service it becomes imperative that optometrists stay
informed of the new techniques, outcomes, and complications of the procedures.
Refractive surgery has become ''big" business as centers appear in most metropolitan
areas. A survey of the nations ophthalmologists, conducted by the American Society of
Cataract and Refractive Surgery examined the methods of practice with respect to
refractive surgery. Refractive surgery attempts to eliminate refractive error, such as
myopia, hyperopia or astigmatism, by manipulating the cornea with surgical blades or
lasers. The survey estimates that the percentage of surgeons performing RK has increased from 31% to 45% from 1992 to 1993/94 [1]. A similar increase is expected with astigmatic keratotomy (AK) as surgeries become perfected. As the numbers above
indicate the procedure has become a major component to the future of eye care. Patients require information regarding refractive surgery to make informed decisions. An article in the May '94 issue of Contact Lens Spectrum points out, primary eye care practitioners, including optometrists, have become more open to refractive surgery than previously believed. Nearly every practitioner questioned has had at least one interested patient, within a three month period, in the prospect of refractive surgery and 400/o of the
practitioners report that 42% of their patients have inquired about refractive surgery [2].
It is obvious that refractive surgery is a treatment option for refractive error and ignoring
it is a disservice to the patient. The following paper is an overview of a number of
common refractive surgeries, with outcomes and complications.