What is Refractive Surgery?

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  • Written By: K T Solis
  • Edited By: Bronwyn Harris
  • Last Modified Date: 20 October 2019
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Refractive surgery is a procedure that can eliminate or lessen the need for wearing eyeglasses or contacts. Whether a person is nearsighted, farsighted, or has astigmatism, refractive surgery can often correct the problem. Undergoing such a procedure enables many people to live their lives without worrying about purchasing new glasses or contacts every one to two years. These eye surgeries are expensive and usually not covered by health insurance.

During the 1980s, a refractive procedure called radial keratotomy (RK) became popular with those who sought freedom from glasses and contacts. During this operation, the surgeon made incisions in the outer areas of the cornea. As a result, the central part of the cornea was flattened. RK surgeries had the ability to correct mild to moderate cases of nearsightedness. During the same time period, a procedure called astigmatic keratotomy was also introduced, where circumferential incisions were made on the cornea. Over time, more advanced refractive surgeries replaced radial keratotomy, but astigmatic keratotomy is still utilized for patients requiring cataract surgery.

One of the most common refractive surgeries performed today is called laser-assisted in-situ keratomileusis (LASIK) surgery. In this particular procedure, the shape of the cornea is changed permanently through use of an excimer laser. A laser device or blade device is used to cut a flap in the surface of the cornea.


The surgeon leaves a hinge on one end of the flap. Next, the surgeon folds back the flap in order to reveal the middle part of the cornea called the stroma. A computer-controlled laser is then used to vaporize a section of the stroma. Once this is complete, the flap is returned to its original position.

Refractive surgery is not a procedure that everyone should receive. People who are pregnant or breastfeeding, those who take medicine that frequently changes their vision, those who are children or in their early 20s, and people whose hormones fluctuate because of diseases like diabetes may have a higher risk of unsuccessful refractive procedures. Those who suffer from autoimmune diseases may also not be good candidates for the procedure since these health conditions interfere with the body's ability to heal after a surgery.

Before approving a patient for refractive surgery, the doctor should ensure that the patient does not suffer from dry eyes, as refractive operations may irritate the condition even further. People with thin corneas are not eligible for the procedure because a refractive surgery conducted on a person with thin corneas could cause blindness. A doctor should also screen a patient for large pupils. Refractive surgeries should not be performed on people with large pupils since this could result in the patient experiencing double vision, glare, starbursts, and halos.

People who suffer from blepharitis, or the inflammation of the eyelids, should avoid refractive surgery as well since the condition often worsens after the procedure. Finally, those who have undergone refractive procedures in the past may not be good candidates for another surgery. Patients in this category should consult with their doctors concerning their particular case.


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