Purpose To investigate the visual sensations experienced by Chinese patients during different styles of refractive surgery, including Epi-Lasik, Lasik and SBK.  

Design Prospective, randomized, self-matched clinical study.

Methods Forty-seven men and 55 women with a mean age of 24.28±0.63  years(range, 16 to 47 years) were studied. 204 eyes had bilateral refractive surgery, including twenty-eight patients had Epi-Lasik, thirty-four patients had Lasik; forty patients had SBK in the same period. They were interviewed postoperatively with a standardized questionnaire about their intraoperative visual experiences, including light perception loss and pain, frightening that were associated with age and surgery duration and other perception.

Results Ninety-seven of the 102 patients experienced various type of visual sensation. A higher proportion of eyes lost light perception in the Lasik group than in the Epi-Lasik group and Sbk group(92.3% vs 97.1% vs 73.0%; Ρ=0.0072).Seventy-one patients were frightened by their intraoperative visual experiences, in which 20 patients(71.4%) in Epi-Lasik group, 23 patients(67.6%) in Lasik group, 28 patients(70.0%) in Sbk group. The patients aged in younger than twenty group who were frightened were more than aged in twenty to thirty group and older than thirty years group, compared to the patients who were not experienced frightening, the difference was significant (Ρ=0.0182).Moreover, the younger age was significantly associated with the higher level of fear (χ² =0.0011). Forty-one patients feel the pain, in which 12 patients(42.8%) in Epi-Lasik group, 18 patients(52.9%) in Lasik group, 11 patients(27.5%) in Sbk group, and the difference P value between three groups was slightly more than 0.05. The mean duration of surgery in five to ten minutes group (8.471±1.566)who felt pain was longer than those who did not feel pain (7.100±1.820) (Ρ=0.0154). Patients also saw flashes, various colors, movements, the surgeon’s fingers, and there was no difference in these visual experiences between Epi-Lasik, Lasik, and Sbk groups.  

Conclusion  More than 90% of the patients experienced various visual sensations. Patients retain light perception during the three types of surgery, when some are temporarily unable to see. Importantly, a younger age, relatively longer duration were risk factors for the visual sensation experienced frightening and pain.