Abstract
The concept of modifying the shape of the cornea to induce changes in the refractive state of the eye is not new, but recent reports of improved success with newer procedures and technologies have generated increased enthusiasm among ophthalmologists and patients anxious to eliminate the need for glasses or contact lenses. However, amid the new wave of excitement persist concerns among many ophthalmologists about predictable efficacy and consistent safety of some refractive surgical procedures.It has been four decades since development of a surgical approach to correct myopia by creating anterior and posterior radial incisions in the cornea.1 Although initial procedures successfully reduced the amount of myopia, nearly 75% of the eyes developed corneal edema in 10 to 20 years, presumably caused by damage to the corneal endothelium.2 Modifications of the early Japanese technique were followed by a shift to anterior radial incisions only, as popularized by the
