ReviewOphthalmology and therapy2021
Ectasia After Corneal Refractive Surgery: A Systematic Review.
Review in Ophthalmology and therapy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 59 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
59 citing papers in PubMed, 2 syntheses or guidelines pooled it, 118 citations in OpenAlex.
- Photorefractive keratectomy in patients with thin corneas: systematic review and meta-analysis of clinical outcomes and complications.Journal of cataract and refractive surgery · 2026Pooled it
- Corneal stability comparison between prophylactic cross-linking with laser refractive surgery technique versus laser refractive surgery technique alone for myopia: a meta-analysis.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2025Pooled it
- Eight-year results of LASIK with or without combined accelerated crosslinking in highly myopic eyes.Journal of cataract and refractive surgery · 2026Trial
- Comparative Diagnostic Efficacy of Swept-Source OCT and Scheimpflug Imaging in Clinically Unaffected Eyes of Very Asymmetric Ectasia.Ophthalmology science · 2026Article
- Refractive Index Engineering for Human Corneal Tissue by Femtosecond Laser Two-Photon Cross-Linking.Journal of biophotonics · 2026Article
- Bromfenac versus nepafenac for pain management following transepithelial photorefractive keratectomy.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2026Article
- Unsupervised phenotyping of suspect keratoconus based on posterior tomography and epithelial remodeling.BMC ophthalmology · 2026Article
- Review
- Motion-Tracking Brillouin Microscopy for Keratoconus Suspect Identification: Comparison With Multimodal Corneal Imaging.American journal of ophthalmology · 2026Article
- Evaluation of stability and visual quality in Chinese myopic eyes 2 years following FS-LASIK combined with prophylactic corneal crosslinking.BMC ophthalmology · 2026Article
- Femtosecond laser-assisted LASIK in the SMILE era: a mini review of patient-centered procedure selection.Frontiers in medicine · 2026Review
- Artificial intelligence in refractive surgery: progress, challenges, and future directions.Frontiers in cell and developmental biology · 2026Review
- Crosslinking for post refractive surgery ectasia: application and clinical outcomes.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2025Article
- Anterior Segment OCT Thickness Difference Maps for Monitoring Corneal Thickness Changes: Small-Incision Lenticule Extraction as a Model.Translational vision science & technology · 2025Article
- Myopia: Still a widespread deviation from the norm or already a pandemic?Journal of cataract and refractive surgery · 2025Article
- Early Posterior Corneal Changes and Belin/Ambrósio Scores Following Photorefractive Keratectomy: A Pentacam Study.Ophthalmology and therapy · 2025Article
- A Novel Approach to Fabricate Early Keratoconus Phantom Models.Translational vision science & technology · 2025Article
- Enhanced Riboflavin Stromal Delivery Using Microchannel-Assisted Iontophoresis for Corneal Crosslinking.Translational vision science & technology · 2025Article
- Polymorphous corneal dystrophy subtype 3 and keratoconus aggravation after corneal refractive surgery in a three-generation family carrying bothFrontiers in genetics · 2025Article
- Development of risk prediction model for small incision lenticule extraction.Frontiers in medicine · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe incidence of ectasia following refractive surgery is unclear. This review sought to determine the worldwide rates of ectasia after photorefractive keratectomy (PRK), laser-assisted in situ keratomileusis (LASIK), and small incision lenticule extraction (SMILE) based on reports in the literature.
methodsA systematic review was conducted according to modified Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Publications were identified by a search of eight electronic databases for relevant terms between 1984 and 2021. Patient characteristics and preoperative values including manifest refractive spherical refractive equivalent (MRSE), central corneal thickness (CCT), anterior keratometry, postoperative residual stromal bed (RSB), and percent tissue altered (PTA) were summarized. In addition, annual rates of each refractive surgery were determined, and incidence of post-refractive ectasia for each type was calculated using the number of ectatic eyes identified in the literature.
resultsIn total, 57 eyes (70 eyes including those with preoperative risk factors for ectasia) were identified to have post-PRK ectasia, while 1453 eyes (1681 eyes including risk factors) had post-LASIK ectasia, and 11 eyes (19 eyes including risk factors) had post-SMILE ectasia. Cases of refractive surgery performed annually were estimated as 283,920 for PRK, 1,608,880 for LASIK, and 96,750 for SMILE. Reported post-refractive ectasia in eyes without preoperative identifiable risk factors occurred with the following incidences: 20 per 100,000 eyes in PRK, 90 per 100,000 eyes in LASIK, and 11 per 100,000 eyes in SMILE. The rate of ectasia in LASIK was found to be 4.5 times higher than that of PRK.
conclusionPost-refractive ectasia occurs at lower rates in eyes undergoing PRK than LASIK. Although SMILE appears to have the lowest rate of ectasia, the number of cases already reported since its recent approval suggests that post-SMILE ectasia may become a concern. Considering that keratoconus is a spectrum of disease, pre-existing keratoconus may play a larger role in postoperative ectasia than previously accounted for in the literature.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.