Laser refractive eye surgery

A. Bastawrous, A. Silvester, M. Batterbury
2011 BMJ (Clinical Research Edition)  
Early attempts at refractive surgery used partial thickness corneal incisions to alter the curvature of the cornea, with the most popular technique being radial keratotomy. In 1990 the Prospective Evaluation of Radial Keratotomy study found that outcomes were unpredictable and unstable, and this led to the use of ablative laser refractive surgery instead. 1 We review evidence for the efficacy of laser refractive surgery mainly from randomised controlled trials and discuss suitability,
more » ... cations, and potential complications of the procedure to help generalists in answering patients' queries. Fig 2 (A) Intact cross section of the cornea. (B) Photoreactive keratotomy: epithelium is removed, exposing the corneal stroma, which is then ablated. (C) Laser epithelial keratomileusis: as for photoreactive keratotomy except that the sheet of epithelium is preserved and replaced. (D) Laser assisted in situ keratomileusis: a hinged partial thickness corneal flap is cut by a microkeratome or a femtosecond laser, the flap is folded backwards, and the underlying stromal bed is ablated; the flap is then replaced. (E) Centrally flattened cornea after myopic treatment
doi:10.1136/bmj.d2345 pmid:21508060 fatcat:umxqusmsxrbsvbde2pyz6la6aa