Does Corneal Refractive Surgery Increase the Risk of Retinal Detachment? A Literature Review and Statistical Analysis

Abstract

To evaluate the association between corneal refractive surgery and the risk of developing retinal detachment. PubMed and Web of Science were the main resources used to search the medical literature. Presumed mechanisms by which corneal refractive surgery would induce retinal detachment include biomechanical changes caused by a suction ring, excimer laser shock-wave, or the use of a femtosecond laser. However, the reported retinal detachment rates after corneal refractive surgery are similar to those of an unoperated myopic cohort. No differences were found between retinal detachment rates in laser in situ keratomileusis and superficial corneal refractive surgery. The pooled analysis found an overall risk of developing retinal detachment after laser in situ keratomileusis of 0.08% (95% CI: 0.69% to 0.82%). Higher preoperative refractive error, patient age, and male gender were associated with an increased risk of retinal detachment. The current analysis presents no convincing evidence to support the causal relationship between corneal refractive surgery and retinal detachment. Patients at risk of developing retinal detachment should be treated with caution and informed that corneal refractive surgery reduces the refractive error, but does not eliminate the risks related to myopia. [J Refract Surg. 2019;35(8):517-524.].