Corneal refractive surgery and the risk of retinal detachment

Abstract

AbstractPurposeCorneal refractive surgery (CRS) is an elective procedure presenting a low risk of complications. Nevertheless, as commonly eyes with perfect best corrected visual acuity are treated, sight‐threatening complications are a major concern. The aim of this study was to evaluate the association between corneal refractive surgery and the risk for developing retinal detachment (RD).MethodologyPubMed and Web of Science were the main resources used to search the medical literature search.ResultsPresumed mechanisms by which CRS would induce RD include biomechanical changes caused by the suction ring, excimer laser shock wave or the use of femtosecond laser. However, the reported RD rates after CRS were similar to those of an unoperated myopic cohort. We found no differences between RD rates in laser in situ keratomileusis and superficial CRSs. The pooled analysis found an overall risk of developing RD after laser in situ keratomileusis of 0.08% (95% CI: 0.69%–0.82%). Higher preoperative refractive error, older patients age and male sex were associated with an increased risk of developing RD after CRS.ConclusionsThe current analysis presents no convincing evidence supporting the association between CRS and increased risk for developing RD. Patients at risk of developing RD should be treated with caution and informed that CRS reduces the refractive error, but does not eliminate the risks related to myopia.