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It is an honour to present the very interesting field of refractive surgery in this special issue on Ophthalmology of the prestigious Bombay Hospital Journal. Refractive surgery has metamorphosed from its first form of keratomileusis fifty years ago to wavefront-guided LASIK of the present day. Refractive surgery for the treatment of myopia, hypermetropia and astigmatism has in recent times gained widespread acceptance among the general population. This may be primarily due to the quick, painless recovery and generally excellent outcomes after LASIK (laser-assisted stromal in-situ keratomileusis). LASIK continues to evolve, taking new directions in instrumentation, techniques, and in our knowledge of how to deal with problems, new and old, that are inherent in any surgical procedure.

Patient expectations have increased over the years and it is heartening to know that technology is keeping up in terms of better predictability of the refractive outcome, the postoperative quality of vision and the intra and para-operative experience of the patient. Wavefront-guided LASIK is a technological advancement on LASIK, which is now the established and most widely performed type of refractive surgery. With amazingly accurate excimer lasers now available, so-called ‘super vision’ is becoming a reality. The exciting possibility of being able to perfectly fine-tune the optical system of the eye to obtain sharp retinal images resulting in vision approaching the retinal limit has resulted in tremendous research activity in the field. In today’s fast-paced world, issues such as glare and poor contrast sensitivity in the post-operative refractive surgery patient need to be a thing of the past. It is not necessary that wavefront-guided treatments will increase the visual acuity from the pre-op best corrected visual acuity. Nor is it that all patients will benefit from it. What is important is that undergoing a refractive procedure will not compound the optical errors of the eye, which is what happened with previous procedures. Translated, the patient will enjoy the same contrast and symptom-free vision without the need for visual aids.

Refractive surgeons with experience in wavefront-guided LASIK have shared their knowledge and experiences in this issue.

The quality of care available to patients has continued to improve as a direct result of the tradition of sharing knowledge and experiences between colleagues. It is the desire of the contributors of this issue to continue the tradition by sharing our experiences and perspectives for the benefit of both patients and colleagues. It is our hope that this issue will achieve its goals.

I would like to thank all those associated with me in my foray into the challenging field of refractive surgery.

I thank Dr. OP Kapoor for his guidance and Dr. RJ Mehta and the staff at the Bombay Hospital Journal office for their kind help in bringing out this issue.


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