Refractive surgery: through the looking glass.

Historically, surgical procedures designed to change the refractive power of the cornea have been controversial at their inception, gaining acceptance only with time and study. From intraocular lenses to corneal remodelling with the excimer laser, and numerous procedures in between, including radial keratotomy, epikeratophakia, incisional keratotomy for astigmatism, and hydrogel and polysulfone implants, ophthalmologists have balanced the risks and benefits for their patients to produce the maximum benefit at the least cost. The present status and future potential of each of these are assessed as they appear today. There is no question that progress will continue, and that our patients will be the beneficiaries of our ongoing interest in improving older procedures and developing new techniques for the correction of refractive errors.