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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,doi:10.1136/bmj.d2345 pmid:21508060 fatcat:umxqusmsxrbsvbde2pyz6la6aa