AAO 2025: Advancements in laser refractive surgery

Arjan S. Hura, MD, a refractive and cataract surgeon from the Maloney-Shamie-Hura Vision Institute in Los Angeles, discussed the significant advancements in laser vision correction in 2025. He highlighted the evolution of LASIK technology, culminating in the next-generation ray trace-enabled WaveLight Plus LASIK, which allowed patients to achieve unprecedented visual outcomes.

Hura emphasized the notable difference between 20/20 and 20/10 vision, sharing that many patients were experiencing 20/10 vision as early as the first day after surgery. He noted that patients could distinctly perceive the difference between these vision levels, making the technological advancement particularly exciting.

The surgeon stressed the importance of a personalized approach to vision correction. He explained that determining the right procedure for a patient was a nuanced process that required understanding their lifestyle, profession, expectations, and unique eye anatomy. Notably, he turned away 10-15% of patients seeking vision correction if they were not suitable candidates.

Hura outlined different procedures for various patient profiles. For high myopes (those with prescriptions beyond -6 or -8), he recommended EVO ICL surgery due to its reversibility and better nighttime vision quality. For patients between -1 and -6 with healthy corneas, laser vision correction was typically suggested. Patients in their mid-40s to early 50s might be recommended refractive lens exchange.

A critical aspect of his approach was managing patient expectations. He acknowledged that patients often came with unrealistic expectations based on friends' or family members' experiences. Hura dedicated significant time to understanding each patient's unique scenario, ensuring they understood the potential outcomes and limitations of their specific case.

Throughout his discussion, Hura emphasized the importance of ethical medical practice. He prioritized patient safety and transparency, always willing to explain why a particular procedure might not be suitable for an individual, even if it meant recommending continued use of glasses or contact lenses.