Conclusions Assessments of three surgical methods to correct errors of refraction in the eye (PRK, LASEK, and LASIK) yield similar results in myopia up to –6 diopters. In 96% to 99% of the cases, surgery results in visual acuity of 0.5 or more in the operated eye. The corresponding results in hyperopia up to +3.5 diopters are 87.1% to 89.5% for PRK, 90.3% to 90.7% for LASEK, and 93.1% to 97% for LASIK. The percentages reaching full visual acuity (1.0 or more) are substantially lower. These conclusions are rated as Evidence Grade 1 – strong scientific evidence.

The surgical procedures are associated with some risk for permanent side effects, e.g., greater sensitivity to glare and increased contrast. Although many different complications have been reported, individually they are very uncommon. Vision loss (measured as two lines or more on the eye chart – a general measure of complications) is unusual with moderate errors of refraction. These conclusions are rated as Evidence Grade 1 – strong scientific evidence.

There is insufficient scientific evidence to draw firm conclusions on the cost-effectiveness of these methods. Considering treatment outcomes, complication risks, and surgical costs, LASIK would appear to be the most cost-effective. This, however, does not apply to high levels of refractive error.