Refractive surgery

Myopia (nearsightedness) and hyperopia (farsightedness) are almost equally distributed in the general population but myopia has received the most surgical attention, probably because it produces the greater disability. It also seems more amenable to surgical correction as the widespread successful employment of radial keratotomy bares out. On the other hand, attempts at surgically correcting hyperopia such as hexagonal keratotomy; thermokeratoplasty; hyperopic lamellar keratotomy, and keratophakia have had a less happy experience. Even the more sophisticated technique of laser photoablation is unable to successfully manage hyperopia. It would seem that steepening the cornea is much more difficult than flattening it. Refractive eye surgery is a new subspecialty of ophthalmology only recently come into its own. Considering the tremendous changes in cataract surgery in the past 30 years it is likely that hyperopia will eventually fall to the refractive eye surgeon.