Overview of Laser Refractive Surgery

Since approval of the use of the excimer laser in 1995 toreshape the cornea, significant developments in the correctionof refractive errors such as myopia, hyperopia, and astigmatismhave been achieved. Combined with other advanced ophthalmologicalinstruments (e.g. anterior segment imaging systems,the femtosecond laser, wavefront-guided customized ablation)and the knowledge accumulated concerning the basic scienceof refractive errors (e.g. biomechanics and wound healing ofthe cornea, higher-order aberrations), laser refractive surgeryhas promisingly outshone other conventional techniques (e.g.radial keratotomy [RK], automated lamellar keratectomy[ALK]) in terms of both safety and efficacy. Photorefractivekeratectomy (PRK) produces stable and predictable resultswith a safe profile. Similarly, laser in situ keratomileusis(LASIK) is also safe and efficacious with the additional advantagesof rapid visual recovery and minimal postoperative pain. The choice between the twomethods is made only after thoughtful discussion between the surgeon and the patient.Despite these advances, certain limitations and complications do exist. There are also specificand controversial circumstances for which studies should be conducted to make furtherbreakthroughs and avoid annoying complications. In this review, the basic knowledge, surgicalissues, and clinical outcomes, of laser refractive surgery, as well as complex cases, willbe presented.