The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on photorefractive (laser) surgery for the correction of refractive error.
It replaces the previous guidance on laser in situ keratomileusis for the treatment of refractive errors (Interventional Procedures Guidance no. 102, December 2004), following consideration of a systematic review of LASIK and LASEK.
Refractive error includes myopia, hyperopia, astigmatism and presbyopia; these are usually corrected by wearing spectacles or contact lenses. Modifying the shape of the cornea can reduce myopia, hyperopia and astigmatism. Corneal reshaping is achieved in photorefractive surgery using excimer laser ablation and is indicated in the range of refractive error from +6 dioptres (D) of hyperopia to –10 D of myopia, with up to 4 cylinders of astigmatism. Excimer laser refractive surgery techniques in current use include photorefractive keratectomy (PRK), laser epithelial keratomileusis (LASEK) and laser in-situ keratomileusis (LASIK).
Photorefractive keratectomy (PRK):
C44.4 Photorefractive keratectomy
Laser epithelial keratomileusis (LASEK):
C44.5 Laser subepithelial keratomileusis
Laser in situ keratomileusis (LASIK):
C44.2 Laser in situ keratomileusis