Development and Evaluation of Refractive Surgical Procedures

Many types of keratoplasty operations are currently in clinical use: penetrating, refractive, and tectonic. These operations ore passing through five stages of development and evaluation: 1) creative innovation; 2) trial and error refinement; 3) informal testing; 4) formal trials; and 5) randomized controlled trials. The further along this continuum an operation proceeds, the more likely ophthalmologists and patients are to have objective, definitive, verifiable information about it. No randomized controlled trials of refractive surgery have been done. There is a need to design trials that test two procedures in a single patient - one in the right eye and the other in the left. This will provide more reliable Information for clinical practice.