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Corneal refractive surgery affects the vitreoretinal interface
 Shalesh Kaushal |
LONDON — Corneal refractive surgery causes a mild concussive injury to the eye that affects the vitreoretinal interface, according to a speaker at the Euretina meeting here.
"In the most common refractive procedure, that's LASIK, it is the suction ring to destabilize the eye, and in this respect there is no difference between using a keratome or a femtosecond laser," Shalesh Kaushal, MD, said.
Globe deformation in the anteroposterior axis occurs, Dr. Kaushal said. The cornea is pulled forward and lens thickness decreases, but there is no change in anterior chamber depth. The vitreous is pulled anteriorly, causing traction that may eventually lead to postoperative vitreoretinal changes, retinal tears and detachment in some cases.
Studies have shown that the incidence of both posterior vitreous detachment and retinal detachment is low after refractive surgery. In a study by Arévalo and colleagues, the retinal detachment rate in a cohort of 32,000 patients was 0.3%. Patients with higher refractive errors had an elevated risk.
However, careful assessment of retinal conditions by adequate and appropriate fundus examination should always be carried out by refractive surgeons before and after refractive procedures, Dr. Kaushal said.
- Disclosure: Dr. Kaushal has no relevant financial disclosures.