Reasons for not performing refractive surgery

Purpose: To analyze the reasons that laser in situ keratomileusis (LASIK) or photorefractive keratectomy (PRK) were not performed in patients who requested surgical correction of their refractive errors. Setting: Minamiaoyama Eye Clinic, Tokyo, Japan. Methods: This retrospective review comprised 2784 consecutive patients who visited our clinic between June 1997 and August 2000. The reasons they did not receive refractive surgery (PRK or LASIK) were analyzed. Results: Among the 2784 patients who requested surgery for refractive errors, 2079 patients (74.7%) had PRK or LASIK and 705 patients (25.3%) did not. The most common reasons for not treating patients surgically were myopia greater than −12.0 diopters and/or high astigmatism (20.7%), insufficient corneal thickness (8.2%), keratoconus (6.4%), cataract (5.7%), and hyperopia and/or hyperopic astigmatism (4.1%). Conclusions: Patients who request surgery have a variety of problems. Attention must be given to these individual problems, and the indications must be considered.