Причины отказа в проведении лазерной рефракционной коррекции роговицы кандидатам на рефракционную хирургию в Южной Индии

Reasons for declining corneal refractive laser correction for refractive candidates in Southern India.

Laser refractive surgeries refer to correcting refractive errors using an excimer laser to reshape the corneal curvature. There are two main techniques: (a) Flap or lamellar procedures such as automated lamellar keratoplasty, laser-assisted in situ keratomileusis (LASIK), and refractive lenticule extraction (ReLEx). ReLEx includes femtosecond lenticule extraction and small-incision lenticule extraction (SMILE); (b) Surface procedures such as photorefractive keratectomy (PRK), transepithelial photorefractive keratectomy, laser-assisted subepithelial keratomileusis (LASEK), epithelial laser keratomileusis (Epi-LASIK) and customized transepithelial No-touch (C-TEN) are popular corneal refractive surgical procedures that replace spectacle and contact lenses in young adults.[¹] A recent systemic review and meta-analysis reported similarities in visual outcomes and quality among commonly used refractive procedures such as LASIK, PRK, LASEK, and Epi-LASIK. Despite high predictability, patient satisfaction, and efficacy, postoperative night glares reduced contrast in low lights, and corneal ectasia can occur.[²,³] Most preoperative screening with corneal topography, tomography, and biomechanical assessment aims to identify high-risk candidates for ectasia. But, there are many concerns, such as the prediction of postoperative wound healing, dry eyes, etc., that may also determine the procedure’s success. A thorough previous ocular and systemic medical and surgical history and blood investigations would help rule out collagen vascular disorders, diabetes, and other systemic diseases that may delay the wound healing mechanism of the cornea after the excimer laser. Phakic intraocular lens (IOL) has become an attractive alternative procedure for patients for whom LASIK is rejected.[¹,²,³,⁴,⁵] In this study, we aimed to analyze the ocular and systemic reasons for LASIK rejection in the South Indian context and compare the regional variation with the literature review.