Refractive surgery refers to any procedure that corrects or minimizes refractive errors. Today, refractive surgery has evolved beyond the traditional laser refractive surgery, embodied by the popular laser in situ keratomileusis or 'LASIK'. New keratorefractive techniques such as small incision lenticule extraction (SMILE) avoids corneal flap creation and uses a single laser device, while advances in surface ablation techniques have seen a resurgence in its popularity. Presbyopic treatment options have also expanded to include new ablation profiles, intracorneal implants, and phakic intraocular implants. With the improved safety and efficacy of refractive lens exchange, a wider variety of intraocular lens implants with advanced optics provide more options for refractive correction in carefully selected patients. In this review, we also discuss possible developments in refractive surgery beyond 2020, such as preoperative evaluation of refractive patients using machine learning and artificial intelligence, potential use of stromal lenticules harvested from SMILE for presbyopic treatments, and various advances in intraocular lens implants that may provide a closer to 'physiological correction' of refractive errors.
摘要: 屈光手术是指矫正或减少屈光不正度数的任何手术。如今, 屈光手术已经超越了传统的手术方式, 以流行的激光原位角膜磨镶术或”LASIK”为代表(laser in-situ keratomileusis, LASIK)。新的角膜屈光技术如小切口角膜基质透镜取出术 (small incision lenticule extraction, SMILE) 避免了角膜瓣的产生和使用单一激光设备, 另外, 表面消融技术的进步使其的流行度回升。老花眼治疗方案也已扩展到涉及新的消融方式, 角膜内植入物和人工晶状体植入物等方面。随着屈光镜片更换的安全性和功效的提高, 具有更先进光学技术的人工晶状体植入物为精心挑选的患者提供了更多屈光矫正手术的选择。在这篇综述中, 讨论了2020年以后屈光手术可能的发展, 例如机器学习和人工智能用于屈光手术患者的术前评估, 从SMILE中获得的角膜基质透镜在老视治疗中的潜在应用, 以及人工晶状体植入物的各种进步可以提供更接近屈光不正的“生理性的矫正”。.