[Does refractive surgery really make eyeglasses superfluous?].

Spectacles have become a problem of life-style in some societies. In the USA, in 1999 approximately 1 million LASIK operations have been performed to correct myopia and astigmatism and in Europe the frequency of refractive surgery stead by increases. However, only 3 to 5% of these operations are medically indicated. Refractive surgery is evaluated regarding safety and efficacy. Modern laser techniques demonstrate excellent refractive results: photorefractive keratectomy (PRK) achieved refractive success rates of 90% and more with complication rates of 0.5% and less. PRK is, therefore, a valuable technique for corrections of myopia up to -6.0 D. Similar efficacy is obtained with LASIK (laser in situ keratomileusis) in corrections up to -10 D, however, the complication rate is somewhat higher. Laser correction of hyperopia is equally successful regarding the refractive success but shows an even higher complication rate and the patient satisfaction is lower. Modern refractive laser surgery may replace spectacles in the majority of the cases, however, none of the techniques is free of complications. Therefore, we understand refractive surgery still to be inferior to the correction of ametropia by means of spectacles and any such operation should be attempted only after thorough discussion.