1. Summary of programme area and objectives

1.1 The general term "Refractive Surgery" covers a range of surgical procedures performed on the cornea (the eye's surface), that are designed to reduce dependency on glasses or contact lenses. Refractive Surgery can be performed to reduce multiple defects in vision such as nearsightedness and astigmatism. The particular procedure is tailored to the individual problem of each patient.

1.2 About 50 percent of the population have refractive errors or defects in the ability of their corneas to focus light, which could be corrected to give them sharper vision. This programme supports projects to understand the topographic and biomechanical properties of the cornea that result in a normal refraction, to understand the biological effects of contact lens wear on the cornea, to develop instrumentation to measure and correct refractive error, to understand the response of the cornea to refractive surgery, and to investigate the epidemiology of refractive error in the population.

  2. Programme plan

2.1 Incidence, prevalence and morbidity - The morbidity and burden on the population of some of the corneal & external eye disorders has been the subject of few studies. Disease quantification is, however, lacking in many disorders; an example which is of current public health importance, is our ignorance of the prevalence of disabling complications of refractive surgery, itself almost exclusively undertaken outside the NHS.

2.2 Refractive surgery - Refractive surgery is a rapidly developing field in the private sector. The place of refractive surgery in the clinical care of patients with eye diseases, such as very short sight, and quality of life assessments for different methods of correcting refractive errors should be assessed.

  3. Future development work in the programme during 2002/3

The research programme will focus on:

· identification of most effective procedure and device
· evaluation of technological advances
· long term effect of refractive surgery in terms of efficacy and safety
· complications, adverse events and clinical outcomes
· qualitative studies of outcomes from the patient's perspective