The eye surgery of the new century, by far, is refractive surgery. The vast majority of this type of surgery is carried out in developed countries, it frequently involves high technology like lasers and computers, patients have very high expectations of the surgery and demand very detailed explanations about results and complications, and there is a growing medico-legal industry related to the outcome of refractive surgery. Many other subspecialties of ocular surgery are beginning to reflect all these elements of refractive surgery to varying degrees. As an illustration, the idea of thorough informed consent and its related practices, such as the use of extremely long and explicit consent forms, information pamphlets, and educational movies, are concepts that originally emerged prominently in refractive surgery but are now extending to other fields of ophthalmology. Refractive surgery is the best place to start today if we want to get a sense of how ophthalmology will develop over the next millennium.
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