Although refractive surgery for many people yields a good visual result, there are certainly some complications that can arise as a result of refractive surgery.  One of the significant visually disturbing complications is corneal ectasia.  Ectasia is when the overall rounded structure of the cornea becomes irregular.  Since ectasia can be visually debilitating, screening for risk factors to identify the possibility of developing ectasia after surgery needs to be improved.  A study looked at 171 cases of ectasia.  Of these cases of ectasia, 164 were from LASIK and 7 were from PRK.  Comparing these cases with controls, it was found that ectasia developed more often when there was preoperative abnormal topography, younger age, higher myopia, thinner corneas prior to surgery and less residual stromal bed thickness.  Of these, the preoperative abnormal topography was the greatest indicator that ectasia will develop after refractive surgery.  Hopefully the data from this study as well as follow up studies will lead to better screening techniques to avoid post surgical ectatic complications. 

Dry eye is certainly a significant problem.  A study looked at the effect of topical Cyclosporin (Restasis), punctal occlusion and a combination of both together and the objective effect on dry eye as well as the effect on reducing the need to use artificial tears.  The Restasis was used twice a day and the punctal occlusion was done on the lower lids only using Parasol plugs.  The effect at six months of either treatment or the combination improved the objective signs as well as the artificial tear use although the rates of improvement were different.  The punctal occlusion regimens improved the initial wetness of the eye while the Cyclosporin improved the longer term ocular surface health.  There also may be an additive effect of both together.

In a journal report, there was a case of a perforating eye injury from a nail gun.  The nail entered the eye and was retained inside the eye.  The vision was severely decreased as would be expected in this type of injury.  Through timely and extensive surgery, the eye was returned to final best corrected vision of 20/20.  This case once again shows the importance of proper training and use of safety equipment.  With the proper safety equipment this might have been totally prevented.  Fortunately in this case, timely care resulted in a good outcome for this individual.

Athletes are always looking for anything that will enhance their performance and give them an "edge."  One such area that has been discussed heavily is the subject of increasing contrast sensitivity by using amber sport-tinted contact lenses.  The idea behind this is that the sharper and crisper the vision is made, the more likely that the athletic performance will be maximized.  Professional and collegiate football athletes were enrolled in a study to test the effect of these vision enhancing contact lenses.  The amber contact lenses were compared with clear contact lenses as well as no contact lenses when those specific athletes required no vision correction.  The results of the study showed a significant improvement in the contrast sensitivity in the group wearing the amber sport-tinted lenses, however the clinical benefits were not clearly demonstrated.  This means that although there is improvement in the contrast sensitivity by wearing these special tinted lenses, the study was not able to show that the athletic performance would be enhanced.