<- Home <- Arhive <- Vol. 31, Issue 2, June 2023



Rom J Leg Med31(2)166-172(2023)
DOI:10.4323/rjlm.2023.166
© Romanian Society of Legal Medicine


THE GROWING BURDEN OF REFRACTIVE VICES AND REFRACTIVE SURGERY

P. F. Curcă, C. Enachescu, C. I. Tătaru, M. Burcea, C. P. Tătaru,


Abstract: Introduction: Refractive vices (myopia, hyperopia and astigmatism) decrease visual acuity and quality. This visual impairment is surgically treatable by refractive surgery.
Materials and Methods: The study’s aim was to establish a clearer picture of current and future prevalence trends of refractive vices and the societal and medical role that laser-assisted refractive surgery is to play in this picture.
Results: The prevalence of myopia has increased alarmingly due to modern life factors such as long study hours and inadequate indoor light in lieu of outdoor sufficient light, to the point that myopia is set to become the de facto normal; astigmatism also presents lower rising trends, while hyperopia’s prevalence remains the same. Refractive surgery was most successful in correcting myopia and myopic astigmatism by Trans-PRK, SMILE and variants of LASIK. Personalized corneal reshaping techniques such as topography-guided LASIK (Alcon Contoura, Phorcides) or Trans-PRK (SCHWIND) allow absolute astigmatism correction by reshaping the cornea to exactly match the individual’s optic system. In high myopes LASIK can achieve up to -18.5 Diopters correction provided sufficient corneal tissue is available; otherwise phakic intraocular lens implants are an excellent and safe alternative. The implantable collamer lens (ICL) is placed in front of the natural lens and can be combined with laser surgery to achieve huge corrective potential (bioptics surgery). For hyperopia LASIK is most established and reliable with Trans-PRK suitable for only minor correction.
Conclusion: Laser-assisted refractive surgery has advanced greatly with a multitude of techniques to cater safely and effectively to each scenario. In the coming myopic world this surgery will offer major medical and societal benefits.
Keywords: refractive surgery, refractive vices, myopia, prevalence, vision improvement.



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