Emergence of refractive surgery.

A major story of the last 2 decades of the 20th century has been the emergence of refractive surgery. Initially extremely controversial, with modest predictability and debatable safety and long-term stability, surgical modification of corneal curvature has come to be well accepted by the profession and the public. The number of these procedures that will be performed in 2000 may exceed 1.5 million. These procedures will continue to be refined over time, and new procedures designed to treat extreme refractive errors (eg, phakic intraocular lenses) or other problems not currently treatable (eg, presbyopia) will fuel growth in this area. Ultimately, the genetic and environmental influences that result in excessive axial elongation and myopia will be identified, and the progression of myopia in school-aged children will be arrested. The benefit to society of eliminating myopia and other refractive errors in the next century will be enormous, allowing the reallocation of enormous resources away from corrective lenses and toward research into treatments for blinding diseases.