The current and future status of refractive surgery.

Kerato-refractive surgery has developed rapidly over the past decade. Many surgical procedures have been described for the correction of myopia, hyperopia, and aphakia. For the treatment of myopia, radial keratotomy has been utilized extensively. Most investigators agree that radial keratotomy results seem to be better in patients with 3 diopters or less of myopia. Keratomileusis is a complicated procedure which can correct high degrees of myopia, however, this technically difficult procedure is performed by very few surgeons in North America. Epikeratophakia for the treatment of aphakia is promising especially in the treatment of pediatric patients. The Excimer laser is evolving from a research tool to clinical reality with the coupling of the laser to computer controlled programs to reshape the cornea. The use of synthetic material inlays and intrastromal corneal ring implants are also being developed to modify the refractive status of the cornea.