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Educational draft · awaiting clinical reviewUse Rapid for revision, not patient-care decisions. Check current national and local guidance and the BNF or BNFC before acting.
RapidMLAMSRAGP

Refractive-surgery principles and complications

Essential points for quick revision.

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Worsening symptoms after refractive surgery

Increasing pain, photophobia, redness or reduced vision after corneal or lens surgery can indicate infection, significant inflammation, pressure elevation or a structural complication.

Action: Arrange urgent review by the operating service or emergency ophthalmology. Do not wait for routine follow-up or start leftover steroid drops without specialist assessment.

Synopsis

Compare corneal and lens-based refractive procedures, identify suitability issues and recognise postoperative symptoms requiring urgent specialist review.

  • Corneal laser procedures alter focusing power by changing corneal shape; they do not shorten the eye.
  • LASIK reshapes beneath a flap, surface procedures reshape after epithelial removal, and SMILE extracts a stromal lenticule.
  • Phakic implants leave the natural lens in place; refractive lens exchange removes and replaces it.

Key red flags

A corneal white spot, worsening pain or discharge after laser treatment suggests infection and needs urgent examination.

Investigation priorities

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Repeated refraction and visual acuityFirst step

Confirm stability and establish the best corrected visual potential.

Management branches

Assess and discussChoose a realistic refractive plan

An adult requests a procedure to reduce reliance on optical aids.

  1. Clarify visual priorities, occupation, sports, night driving and tolerance of possible residual spectacle use.
  2. Complete refractive, corneal and ocular health assessment and discuss spectacles or contact lenses as continuing alternatives.
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Sources and review status8 sources · checked 7 Sept 2026 · clinical review pending
Sources

Sources and review status

National guidance is shown before implementation-dependent detail. Typical adult dose examples remain subject to patient factors, contraindications and the live BNF or specialist protocol. Source check completed 7 Sept 2026; clinical approval remains outstanding.

Authoring stateRapid draftClinical stateAwaiting reviewJurisdictionUnited Kingdom