Application of corneal biomechanics in corneal refractive surgery

Corneal refractive surgery has fulfilled the needs of a growing number of patients seeking spectacle independence, thanks to its favorable corrective outcomes and high safety profile.However, corneal refractive surgery alters the cornea’s structural organization while correcting refractive errors, which leads to a reduction in corneal biomechanical strength.Serious complications such as postoperative corneal ectasia occasionally occur.As a result, corneal biomechanics has gained widespread attention in the field of refractive surgery.This article reviews the structure and biomechanical properties of the cornea, current clinically commonly used methods for assessing corneal biomechanics, potential novel measurement techniques, as well as the clinical application of corneal biomechanics alone or in combination with corneal topography in screening for keratoconus prior to refractive surgery.Additionally, the impact of different refractive surgical techniques, such as photorefractive keratectomy, laser in situ keratomileusis, and small incision lenticule extraction, on corneal biomechanical properties are discussed.Finally, the application of corneal biomechanical measurements in evaluating postoperative corneal safety is summarized.