Corneal Biomechanics Losses Caused by Refractive Surgery

Curr Eye Res. 2022 Aug 24:1-7. doi: 10.1080/02713683.2022.2103569. Online ahead of print.ABSTRACTRecent advances, specifically in the understanding of the biomechanical properties of the cornea and its response to diseases and surgical interventions, have significantly improved the safety and surgical outcomes of corneal refractive surgery, whose popularity and demand continue to grow worldwide. However, iatrogenic keratectasia resulting from the deterioration in corneal biomechanics caused by surgical interventions, although rare, remains a global concern. On one hand, in vivo biomechanical evaluation, enabled by clinical imaging systems such as the ORA and the Corvis ST, has significantly improved the risk profiling of patients for iatrogenic keratectasia. That is despite the fact the biomechanical metrics provided by these systems are considered indicators of the cornea's overall stiffness rather than its intrinsic material properties. On the other hand, new surgical modalities including SMILE were introduced to offer superior biomechanical performance to LASIK, but this superiority could not be proven clinically, creating more myths than answers. The literature also includes sound evidence that tPRK provided the highest preservation of corneal biomechanics when compared to both LASIK and SMILE. The aim of this review is twofold; to discuss the importance of corneal biomechanical evaluation prior to refractive surgery, and to assess the current understanding of cornea's bi...
Source: Current Eye Research - Category: Opthalmology Authors: Source Type: research