Mechanical methods in refractive corneal surgery.

Area of Science:

• Ophthalmology
• Refractive Surgery
• Corneal Surgery

Background:

• Refractive surgery techniques are continuously evolving.
• Established and novel surgical methods for vision correction are under scrutiny.
• Key areas of interest include myopia, hyperopia, and astigmatism correction.

Purpose of the Study:

• To review recent developments and ongoing debates in mechanical refractive surgery.
• To assess the current status and challenges of various refractive surgical procedures.
• To highlight safety, predictability, and visual acuity outcomes.

Main Methods:

• Review of recent studies and reports on refractive surgical techniques.
• Analysis of clinical outcomes for lamellar in situ keratomileusis, mini-radial keratotomy, astigmatic keratotomy, hexagonal keratotomy, intrastromal corneal rings, and phakic intraocular lenses.
• Evaluation of safety, predictability, and best-corrected visual acuity.

Main Results:

• Lamellar in situ keratomileusis shows potential for moderate to high myopia but has safety and predictability concerns.
• Mini-radial keratotomy may reduce traumatic rupture risk; astigmatic keratotomy nomograms are refined for congenital astigmatism.
• Hexagonal keratotomy for hyperopia and intrastromal corneal rings raise predictability questions, despite some safety reassurances.
• Phakic intraocular lenses (anterior and posterior chamber) for myopia continue to be reported.

Conclusions:

• Significant progress and debate surround mechanical refractive surgery techniques.
• Further research is needed to establish the safety and predictability of newer procedures like lamellar in situ keratomileusis and intrastromal corneal rings.
• Established techniques are being refined, while new lens-based options for myopia are emerging.