Refractive vision problems include astigmatism, farsightedness, or nearsightedness. Treatment for these conditions is refractive surgery.

Refractive surgery includes a variety of surgical treatments that help to improve the eye’s refractive state to reduce dependence on contact lenses or glasses. The procedures help to correct vision by allowing the proper direction of light to the retina.

Refractive surgery options include:

• Refractive lens exchange: A surgical procedure that can be used alongside LASIK surgery to replace the eye’s natural lens with intraocular (artificial lens).

• Photorefractive keratomy: A surgery that removes the epithelium (outer layer of the cornea).

• Laser in-situ keratomileus (LASIK): A type of surgery where the surgeon creates a thin flap in the cornea to correct a refractive problem.

The main objective of the refractive procedure is to minimize contact lenses or glasses dependence. Before undergoing the procedure, you should consult an ophthalmologist and consider the benefits and risks.

Candidates for refractive surgery include people with healthy eyes who want to eliminate the need for contact lenses or glasses and those with refractive errors that need correcting.

You cannot undergo refractive surgery if:

• Your corneas are cone-shaped (keratoconus)
• You have a severe dry eye
• You’ve had your contact lens prescription changed in the past year
• You have a recurrent infection of herpes simplex that involves the cornea
• You have a condition like connective tissue disease, which impairs wound healing
• You’re currently taking drugs like amiodarone or isotretinoin
• You’re under 18 years

Your eye doctor will determine your refractive error by examining your cornea. They’ll check you using topography, pachymetry, and tomography.

Refractive surgery improves vision significantly. Reshaping the cornea through refractive surgery has had a success rate of over 90%. Photorefractive keratomy, for instance, has shown 95% success with people achieving 20/20 vision without the support of corrective lenses. Refractive lens exchange has yielded over 88% success with a visual acuity of 20/40.

Refractive surgery offers convenience, especially to people with contact lens intolerance. In most cases, it eliminates the need to wear contact lenses or glasses.