Indications, results, and complications of refractive corneal surgery with lasers

The use of lasers to correct refractive errors has become an established clinical procedure in many countries. Excimer laser photorefractive keratectomy (PRK) has been performed on an estimated 400,000 to 500,000 eyes worldwide. For myopia up to about 6.0 D, PRK appears to be generally safe, exhibiting acceptable accuracy, predictability, and stability. Complications of PRK can occur intraoperatively, and early or late postoperatively. For higher degrees of myopia, laser in situ keratomileusis may prove to be a more appropriate procedure, but long-term follow-up is needed. Hyperopic PRK and holmium:yttrium-aluminum-garnet thermokeratoplasty are still considered investigational methods, and for newer technologies, such as solid-state lasers, human trials are being launched.