A comprehensive study of surgical procedures performed to correct vision problems such as nearsightedness, farsightedness, and astigmatism by reshaping the cornea.

Introduction to Refractive Surgery

RK (Radial Keratotomy)

PRK (Photorefractive Keratectomy)

Trans PRK (Transepithelial PRK)

LASEK (Laser-Assisted Sub-Epithelial Keratectomy)

LASIK (Laser Assisted in situ keratomileusis)

FEMTO LASIK (Femtosecond LASIK)

SMILE (Small Incision Lenticule Extraction)

Customized Procedure (MS-39)

CLEAR (Cornea Lenticule Extraction)

MCQs on Refractive Surgery

Refractive surgery refers to a group of surgical procedures performed to correct vision problems such as nearsightedness, farsightedness, and astigmatism. These procedures improve eyesight by changing the shape of the cornea so that light entering the eye is properly focused onto the retina.

No laser is used; it is a manual blade procedure.

Rarely performed today as newer laser methods are safer.

Results may change over time (vision instability).

Radial Keratotomy is one of the earliest refractive surgeries used to treat myopia. The surgeon makes small radial (spoke-like) cuts on the cornea to flatten it.

No corneal flap is created, reducing flap-related complications.

Extended recovery period (3 to 7 days) with some discomfort.

A safe outpatient laser surgery that reshapes the cornea without creating a corneal flap. The thin outer corneal layer (Epithelium) is removed and underlying tissue is reshaped with an excimer laser.

No flap complications, good for thin corneas, preferred for athletes.

Discomfort for 2–4 days; recovery takes days to weeks.

Vision improves in 1-2 weeks and stabilizes in 1-3 months.

An advanced version of PRK described as a 'no-touch' laser procedure. The laser removes the epithelium and reshapes the cornea in a single step without blades or alcohol solutions.

Similar to PRK but the epithelial layer is loosened with alcohol, moved aside, and then replaced after reshaping the underlying cornea.

A microkeratome or laser creates a hinged flap.

Most patients return to daily activities within 24 hours.

A painless procedure where a flap (hinged tissue) is created in the outer corneal layer with a handheld surgical device, folded back, and the underlying tissue is sculpted with a laser.

The laser creates a microscopic, uniform flap.

Reduced risk of dry eyes and faster healing than traditional LASIK.

An advanced form of LASIK where the corneal flap is created using a femtosecond laser instead of a blade. This offers improved precision and safety.

Tiny incision (2-4mm) instead of a large flap.

Causes less nerve damage, resulting in less dry eye.

A minimally invasive, flapless procedure where a femtosecond laser creates a tiny disc of tissue (lenticule) inside the cornea, which is removed through a small incision.

Measures curvature and detects astigmatism axis.

Analyzes corneal and epithelium thickness in detail.

Merges datasets for a true 3D corneal model to detect irregularities.

Surgeries guided by the MS-39 diagnostic system, which combines corneal topography (surface mapping) and OCT scanning (cross-sectional layers) for high-resolution 3D analysis.

Uses Ziemer FEMTO LDV Z8 laser for high precision.

Small 2-3mm incision to remove the lenticule.

Leaves the corneal surface largely intact for enhanced stability.

A next-generation, flapless laser surgery using the Ziemer Z8 femtosecond laser. It is a 'keyhole' procedure offering faster recovery and lower dry eye risk.

Refractive Surgery and its Types

Course Outline