Biomechanics of the Cornea and Wavefront-guided Laser Refractive Surgery

Wavefront-guided laser refractive surgery induces postoperative optical aberrations that are not explained by the ablation profile.A conceptual model is presented for a potential mechanism of surgically-induced corneal shape change that is dependent on structural modification, rather than ablation profile.Examples are provided from clinical and basic studies that are consistent with the proposed model.Corneal biomechanical response to ablative surgery may significantly affect outcomes, and should be taken into account when planning customized procedures.