Authors' objectives:

In pursuance of questions raised in parliament, on request of the State Secretary of Health, Welfare and Cultural Affairs to inform him about the state of science, its implications for practice and central regulation, if necessary.

Authors' results and conclusions: Risks, side effects and complications. Efficacy and effectiveness. Clinical: Excimer laser correction of refractive errors is not a medical necessity. The procedure is irreversible and not without risk. There are extremely effective and better-known methods (spectacles and contact lenses) of ameliorating the errors which it is currently used to treat. The reports in the scientific literature are not sufficiently detailed and the results so far are only fair in low myopia to unacceptable in the case of major correction. In order to assess the true value of the procedure a follow-up period of at least five years is required. None of the studies published so far fulfils this requirement.

Authors' recommendations: Excimer laser correction of refractive errors has not yet progressed beyond the experimental stage. It should only be used in patient-based studies. If this method is to be developed (no high research priority), this should not take place in private clinics but in teaching hospitals and should be conducted according to a strict protocol approved by the Ethics Committee of the hospital. Insurance will be required to compensate patients taking part in research for any personal injury suffered i.e. no fault need apply. The cost of treatment should not be borne by clients in the research phase. The optimistic picture presented to clients in no way reflects the state of medical science in this field. Caution in `recruiting' clients and emphasis on the experimental nature of the procedure in the information given to the public are recommended. Other output or dissemination activity: Acceptance of recommendations: Watchful waiting by the Chief Medical Inspectorate for Public Health. No reimbursement. Changes to practice: reticent attitude in the profession. Decline of the number of clinics offering Excimer laser treatment (from 6 to 4).

Authors' methods: Review

Project Status: Completed

URL for project: http://www.gr.nl/

Year Published: 1993

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Netherlands

Organisation Name: Health Council of the Netherlands Gezondheidsraad

Contact Address: Postbus 16052, 2500 BB Den Haag, The Netherlands. Tel: +31 70 340 7520;Fax: +31 70 340 7523

Contact Name: info@gr.nl

Contact Email: info@gr.nl

Copyright: Health Council of the Netherlands Gezondheidsraad