Predictability of the Refractive Effect after Laser Correction. Determining Factors. Review

Abstract

Currently, refractive surgery using modern laser systems for the correction of various types of ametropia is one of the most widespread and performed operations worldwide. It is important to obtain refractive results comparable to those expected, both for the patient and for the surgeon himself. However, in some cases, there may be a deviation of the refractive result from the planned one, and in the late period after the operation, a regression of the refractive effect is detected, which, ultimately, may cause patient dissatisfaction. In order to avoid these situations, it is necessary to have a clear understanding of the risk factors that can lead to these phenomena, and, accordingly, take them into account during planning a surgical intervention.Currently, risk factors for regression and factors that can affect the deviation of the refractive result are divided into 2 groups and are actively studied by both Russian and foreign researchers.Given the relevance of the problem of accurate planning and achieving stable refractive results, various nomograms have been actively developed and implemented recently. The purpose of nomograms is to compensate the influence of various factors by introducing adjustments that can be applied at the planning of the operation. Nomograms are considered reliable and effective tools to increase the predictability of refractive surgery, but, for the most part, are the result of the work of a refractive surgeon. The purpose of this review is to analyze the world literature to determine the risk factors for regression and factors affecting the deviation of the refractive result from the planned one, as well as to analyze the existing nomograms designed to improve the planning and prediction of the results of laser refractive surgery.