British Contact Lens Association

Contact lenses versus refractive surgery

Nowadays glasses are often seen as a fashion accessory, with many celebrities leading the way in wearing stylish frames. Nonetheless, if an opportunity arises to be free from glasses, many people will jump at the chance.

Contact lenses offer this freedom but have the inconvenience of having to put something on the eye and, for most wearers, having to clean the lenses (except with single-use lenses). Refractive surgery offers people the same freedom from glasses and the perception that their eyesight is ‘normal’.

There are now many surgical options available for correcting most eyesight problems. The most common procedure in the UK is LASIK (laser-assisted in situ keratomileusis).

Studies have shown that most patients presenting for refractive surgery are former contact lens wearers, and the reasons they choose refractive surgery are often the same reasons they chose contact lenses initially, such as appearance, work and sport. Many of these people could probably have continued to wear contact lenses successfully if they were advised and managed appropriately by their contact lens practitioner.

Refractive surgery doesn’t always result in complete freedom from spectacles. After surgery, although their eyesight is fine for most tasks, some patients may still need spectacles for distance or near viewing and most will require reading glasses by their mid-40s.

In most cases, refractive surgery is performed on an otherwise healthy eye and is generally irreversible. After surgery, a small proportion of patients experience a decrease in their quality of vision that cannot be corrected with spectacles. For suitable candidates and in the correct hands, the risk of serious, sight-threatening complications with corneal refractive surgery is very small and comparable to daily wear soft contact lenses, although the risk is higher than for rigid gas permeable lens wear. Night vision problems, such as glare, can occur in up to one-third of those opting for certain types of refractive surgery. Success rates vary, but depend on careful surgeon and patient selection. Overall satisfaction rates with LASIK are reported to be 95%, with 5% of patients dissatisfied with the outcome.

If you’re interested in refractive surgery, the first step is to consult your eye care practitioner who’ll advise you on all the options available for correcting your vision. Should you decide to go ahead with surgery, be wary of special offers and, if possible, seek advice from several experts who are able to offer a range of surgical options. Contact the secretary of the British Society for Refractive Surgery (www.bsrs.co.uk) for a list of surgeons in your area.

                                       Main reasons why  patients choose refractive surgery

References

McGhee, H.T. and Mathers, W.D. Laser in situ keratomileusis versus long-term contact lens wear: decision analysis. Journal of Cataract and Refractive Surgery 2009: 35(11);1860-7

Schallhorn, S.C. et al. Comparison of night driving performance after wavefront-guided and conventional LASIK for moderate myopia. Ophthalmology 2009: 116(4); 702-9

Brown, M.C. et al. Satisfaction of 13,655 patients with laser vision correction at 1 month after surgery. Journal of Refractive Surgery 2009: 25(7); S642-6