The excimer laser in ophthalmology: a state-of-knowledge update
Conseil de Evaluation des Technologies de la Sante
Record ID 32001000051
In 1997, CETS published a report dealing specifically with excimer laser photorefractive keratectomy (PRK). Since then, the ophthalmological applications of the excimer laser have continued to evolve at a rapid pace. Furthermore, these applications, which are available essentially in the private sector, given that they are services paid for directly by patients, have been diffused very rapidly. Questions must therefore be asked about the efficacy and safety of this technology.
This report aims to update the assessment of the benefits and disadvantages of PRK and to examine more specifically LASIK (laser in situ keratomileusis). It also provides an overview of the alternatives and future developments, and the research in this field. The indications, contraindications and choice of procedure (PRK or LASIK) are also discussed.
This report concludes that for mild and moderate myopia, PRK and LASIK can now be considered accepted technologies, although there is a lack of long-term follow-up. For the correction of severe myopia and moderate and severe hyperopia, LASIK is still an innovative technology. The reason for this status is uncertainty as to various aspects of its use or even to its indications, unertainty which would need to be eliminated by gathering and systematically analysing data on the use of this technique.
Steps should be taken to better regulate the introduction and diffusion of this technology in Quebec and Canada. Furthermore, since these interventions rarely constitute a medical necessity, the overall obligation to inform the patient should be met with utmost rigor, with the patient being informed of the rare and even extremely rare risks.
English language abstract:
An English language summary is available
- Laser Therapy
Conseil d'Evaluation des Technologies de la Santé du Québec
Conseil d'Evaluation des Technologies de la Santé du Québec, 2021, avenue Union, #1040, Montréal, Québec H3A S29, Canada. Tel: 514-873-2563; FAX: 514-873-1369
Conseil d'Evaluation des Technologies de la Sante du Quebec (CETS)