The purpose of this report is to provide interested parties with an impartial and unbiased view of refractive surgery and the factors that must be considered when drawing up a recruitment policy that is inclusive of individuals who have undergone refractive surgery. This report is for information only and each organisation needs to produce its own guidelines. The report has been produced by the BSRS council, on behalf of the membership.

March 2007 note: This report is a few years out of date now. As it is well written and still contains very useful information, we have left it here. More up to date information can be found from our links page

Dr Catharine Chisholm MCOptom
Lecturer
Department of Optometry
University of Bradford, Richmond Road, Bradford,
West Yorkshire, BD7 1DP, UK.
Tel: 44 (0)1274 234635
C.M.Chisholm@bradford.ac.uk

© British Society for Refractive Surgery and Catharine Chisholm

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(see also blue link bars on left of page)

1 Executive Summary and Introduction *

2 Refractive Errors *

2.1 Myopia (short sight) *

2.1.1 The Correction Of Myopia *

2.2 Hypermetropia (long sight) *

2.2.1 Correction Of Hypermetropia *

2.3 Astigmatism *

2.3.1 Correction Of Astigmatism *

2.4 Presbyopia *

2.4.1 Correction Of Presbyopia *

2.5 The Disadvantages Of Traditional Methods Of Refractive Correction *

2.5.1 Spectacles *

2.5.2 Contact Lenses *

3 Summary Of Refractive Surgery *

3.1 Radial keratotomy (RK) *

3.1.1 Surgical outcomes *

3.1.2 Ocular integrity *

3.1.3 Visual performance *

3.1.4 Conclusions *

3.2 Excimer Laser Procedures *

3.2.1 Photorefractive Keratectomy (PRK) *

3.3 Laser Assisted in-situ Keratomileusis (LASIK) *

3.3.2 LASEK *

3.4 Complications common to all excimer laser treatments *

3.4.1 Customised ablations for excimer laser surgery *

3.4.2 Potential Long-term Consequences Of Photoablation *

3.5 Intra corneal ring segments (ICRS) *

3.6 Holmium Laser ThermoKeratoplasty (LTK) and Diode ThermoKeratoplasty (DTK) *

3.7 Intraocular Refractive Surgery *

3.7.1 Phakic intraocular lenses (PIOL) *

3.7.2 Refractive lens exchange *

3.8 Presbyopia treatments *

4 Visual performance *

4.1 Scattered light *

4.2 Aberrations *

4.3 Night vision *

4.4 Methods of assessing visual performance *

4.4.1 High contrast letter charts *

4.4.2 Contrast sensitivity tests *

4.4.3 Glare testing *

4.4.4 Psychophysical techniques *

5 Practical Considerations When Designing Refractive Surgery Policies *

5.1 Refractive Restrictions *

5.2 Recovery times *

5.3 Assessment of applicants with a history of refractive surgery *

5.4 Detection Of Laser Surgery *

Appendix A - Results *

6 Glossary *

7 References *