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Review
. 2018 Apr-Jun;11(2):121-129.
doi: 10.1016/j.optom.2017.09.002. Epub 2017 Nov 26.

Visual outcomes and management after corneal refractive surgery: A review

Ane Murueta-Goyena  1 , Pilar Cañadas  2
Affiliations
Review

Visual outcomes and management after corneal refractive surgery: A review

Ane Murueta-Goyena et al. J Optom. 2018 Apr-Jun.

Abstract
in English, Spanish

Corneal refractive surgery procedures are widely performed to permanently correct refractive errors. Overall, refractive surgeries are safe, predictable and present high rates of satisfaction. Nevertheless, the induced epithelial, stromal and nerve damage alters corneal integrity and function, triggering a regenerative response. Complications that arise from corneal wound healing process might directly impact on visual outcomes of keratorefractive procedures. Most of these complications can be prevented or effectively treated with minimal consequences and minor impact on optical quality. Nevertheless, it is crucial to accurately and timely identify these corneal regeneration-related complications for successful counseling and management. Optometrists, as primary eye care providers, play an essential role in detecting anatomic and functional alterations in vision. It is therefore of great interest for optometrists to be familiar with the principal postoperative complications derived from alterations in regenerative process after corneal laser refractive surgeries. This review aims to provide a basis for optometrists to better understand, identify and manage the main wound healing-related complications after refractive surgery.

La cirugía refractiva corneal se lleva a cabo a menudo para corregir de manera permanente los errores refractivos. En general, la cirugía refractiva es segura y predecible, y presenta altos índices de satisfacción. Sin embargo, el daño inducido a nivel epitelial, estromal y nervioso altera la integridad y la función de la córnea, y desencadena una respuesta regenerativa. Las complicaciones que surgen del proceso de cicatrización de la herida corneal podrían tener un impacto directo sobre los resultados visuales de los procedimientos queratorefractivos. La mayoría de estas complicaciones pueden prevenirse, o tratarse de manera efectiva con mínimas consecuencias y un menor impacto sobre la calidad óptica. Sin embargo, es esencial identificar de manera precisa y oportuna dichas complicaciones relacionadas con la regeneración de la córnea, en aras de llegar a un asesoramiento y tratamiento satisfactorios. Los optometristas, al ser profesionales sanitarios de atención ocular primaria, juegan un papel esencial a la hora de detectar las alteraciones anatómicas y funcionales de la visión. Por tanto, es muy interesante que los optometristas estén familiarizados con las complicaciones postoperatorias principales derivadas de las alteraciones del proceso regenerativo tras cirugía refractiva corneal láser. Esta revisión tiene como objetivo proporcionar una base a los optometristas para la mejor comprensión, identificación y tratamiento de las principales complicaciones relacionadas con el proceso de cicatrización tras una cirugía refractiva.

Keywords: Cirugía refractiva; Complicaciones; Complications; Corneal regeneration; Refractive surgery; Regeneración de la córnea; Resultados visuales; Visual outcomes.

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Figures

Figure 1
Figure 1
Post-PRK corneal haze before (a) and after (b) treatment with stromal scraping and application mitomycin C. Spadea & Verrecchia. 2011. The Open Ophthalmology Journal.
Figure 2
Figure 2
Central Toxic Keratopathy with loss of central corneal transparency. Image reproduced under Creative Commons Attribution License. Hazin R et al., 2010. Middle East Afr J Ophthalmol. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2880375/.
Figure 3
Figure 3
In this image we can appreciate post-LASIK keratectasia with cornea budged forwards and edematous central cornea. Image reproduced under the CC-NY License. Meyer H et al., 2009. J Ophthalmol. http://www.ncbi.nlm.nih.gov/pubmed/20339447.
See this image and copyright information in PMC

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