Corrective surgery, lens implants and laser treatment for refractive error (short or long sightedness, astigmatism)

For the treatment of

Refractive Error 

Commissioning position

This intervention is commissioned if poor refraction results in loss of functional vision either:  

  1. after corneal transplant or cataract surgery OR  
  2. due to Keratoconus or pellucid marginal degeneration   

AND   

all conservative or other appropriate surgical interventions have failed to adequately correct this impairment.  

Summary of rationale

Wearing glasses or contact lenses is more cost effective and carries lower risk than eye surgery for correcting refractive errors.   

  

Photorefractive (laser) surgery for the correction of refractive errors is safe and efficacious for use in appropriately selected patients. However corrective surgery is not commissioned as an alternative to the use of spectacles or contact lenses as a personal preference on cosmetic grounds.  

  

Corneal lens implants should only be used for the treatment of refractive error when there is other ocular pathology present e.g. keratoconus or pellucid marginal degeneration.  

 

References

Overview | Photorefractive (laser) surgery for the correction of refractive errors | Guidance | NICE

Overview | Corneal implants for keratoconus | Guidance | NICE

Associated Pathways

There are no associated pathways.

Specialties

Ophthalmology York Ophthalmology North Yorkshire Ophthalmology Hull Ophthalmology East Riding Ophthalmology North Lincolnshire Ophthalmology North East Lincolnshire

Places covered by

  • east-riding
  • hull
  • north-east-lincolnshire
  • north-lincolnshire
  • north-yorkshire
  • vale-of-york
Author:
Date created: 12/06/2025, 15:26
Last modified: 16/07/2025, 08:17
Date of review: 2027. 10. 31.