Background-The safety and predictability of refractive surgery for all degrees of myopia is now becoming established. It is therefore appropriate to evaluate whether there is a patient driven demand for such treatments and, if so, to establish guidelines for its provision within the National Health Service (NHS). Methods-A comparative study was designed to assess the eVect of degree of myopia on quality of life ("high" (n = 30) -10.00D, worse eye; "moderate" (n = 40) -4.00 to -9.75D, worse eye; "low" (n = 42) <-4.00D, worse eye) compared with a group of patients with keratoconus (n = 30) treated by optical correction. Data collection included binocular logMAR visual acuity, Pelli-Robson low contrast letter sensitivity, questionnaires to assess subjective visual function (VF-14) and eVect on quality of life (VQOL), and semistructured interviews. Results-There were no significant diVerences in any of the measures between patients with a high degree of myopia and those with keratoconus, or between those with a low and those with a moderate degree of myopia. However, those with a high degree of myopia had highly significantly poorer logMAR, VF-14, and VQOL scores than those with low and moderate myopia (p<0.001). Interview data supported these findings with patients with a high degree of myopia and those with keratoconus reporting that psychological, cosmetic, practical, and financial factors aVected their quality of life. Conclusion-Compared with low and moderate myopia, patients with a high degree of myopia experience impaired quality of life similar to that of patients with keratoconus. Criteria should therefore be identified to enable those in suYcient need to obtain refractive surgical treatment under the NHS. (Br J Ophthalmol 2000;84:1031-1034 Myopia aVects 25% of the population in western industrialised societies and has a potentially negative eVect on self-esteem, career choice, and ocular health.

The diVerences between the prediction errors for both axial length and age were statistically significant (p<0.05). Conclusions-For the overall group IOL power calculation is satisfactory. In eyes with axial lengths less than 20 mm and in children less than 36 months of age larger errors can arise. This study demonstrates the need for an IOL formula specifically designed for paediatric use. (Br J Ophthalmol 2001;85:939-941)

The results show that RGP lenses provided superior visual performances and greater reduction of 3rd-order aberrations compared to toric SCL in this group of keratoconic patients. In the spectacle-wearing group, visual performance with the toric SCL was found to be comparable to that measured with spectacles. Nevertheless, with the exception of spherical aberration, the toric SCL were successful in significantly reducing uncorrected higher-order aberrations.

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