To determine the rate of excimer laser refractive surgery and the economic inequality in its distribution in Iran

Twelve provinces were considered for the study, 8 of which were selected by random, and a number of excimer laser centers were chosen from each province. In the timeframe between 2010 and 2014, one week per season was randomly selected for each center, and the number of surgeries conducted in these 20 weeks was determined by trained personnel

Of the 57 active surgical centers in the 12 surveyed provinces, 28 centers were selected. The rate of excimer laser refractive surgery in 2010 in Iran was 2764 per million population which reached 3744 per million by 2012 and took a slightly decreasing trend to 3582 until 2014. Based on the number of ophthalmologists and the number of surgeries in 2014, the average number of surgeries per ophthalmologist was 103 surgeries. High-income provinces had higher surgical rates. Economic inequity indicated a concentration index of 0.427 (standard error=0.09)

This is the first study to report the rate of excimer laser refractive surgery in Iran. The rate of excimer laser refractive surgery is low compared to the prevalence of refractive errors. In light of the existing economic inequality, it seems that establishing surgical centers in low-income areas and support from the government and insurance organizations can greatly help reduce visual impairment caused by refractive errors