Unraveling the impact of laser refractive surgery on corneal ectasia: an in silico study

While the three refractive procedures showed different behaviors in terms of mechanical changes affecting the cornea, from an optical perspective, as the pathology severity worsened, none of the surgeries caused a worsening in the cone's severity with respect to pre-surgical pathological conditions. This result suggests that surgeries may have a limited role in causing post-surgical ectasia, as it seems more plausible that they accelerate the progression of an underlying pathological condition. Among the three procedures, PRK was found to be the least invasive treatment from a mechanical perspective, while SMILE showed the greatest impact on the posterior surface, suggesting a potential long-term risk for ectasia progression.