Contact lenses versus refractive surgery

Nowadays spectacles 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 spectacles, 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 daily disposable and continuous wear lenses). Refractive surgery offers people the same freedom from spectacles and the perception that their vision is ‘normal’.

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

In most cases, refractive surgery is performed on an otherwise healthy eye and, after the surgery, 3% of patients experience a decrease in their ability to see. The relative risk of serious complications is approximately 100 times that of daily contact lens wear (presuming 10 years of wear). Night vision problems, such as glare, occur in approximately one-third of those opting for refractive surgery. Success rates vary, but depend on careful surgeon and patient selection.

If you are interested in refractive surgery, the first step is to consult your eye care practitioner who will 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. Contact the secretary of the British Society for Refractive Surgery (www.bsrs.co.uk) for a list of surgeons in your area.