title: Advances in Refractive Surgery: May 2013 to June 2014.
abstract: OBJECTIVE
  The field of refractive surgery is changing quickly in the areas of screening, treatment, and postoperative management. The objective of this study was to review advances in the field of refractive surgery as reported in the peer-reviewed literature during the previous year.
  
  
  METHODS
  This was a literature review.
  
  
  METHODS
  In this article, we highlight the progression in the field from May 2013 to the end of June 2014. This article is organized as preoperative, intraoperative, and postoperative considerations.
  
  
  RESULTS
  The growing use of newer modalities of treatment, such as small-incision lenticule extraction (SmILE) and phakic intraocular lenses, and their safety and efficacy add to the armamentarium in treating refractive error. This past year has seen many studies, which show these procedures to be safe and effective. Also, structurally, SmILE may result in a more biomechanically stable cornea, so that we may be able to safely treat higher refractive errors.
  
  
  CONCLUSIONS
  While laser-assisted in situ keratomileusis is the predominant surgical procedure, photorefractive keratectomy is still an appropriate choice in certain scenarios (higher risk for ectasia postrefractive surgery and patient choice) with safe, predictable results, and patient satisfaction. Many of the new developments in laser-assisted in situ keratomileusis have focused on flap creation with femtosecond lasers. Histopathology and in vivo optical coherence tomography studies have shown that the stromal bed is smoother, the side cuts are vertical, and the flap has predictable thickness. New surgical modalities, such as femtosecond lenticule extraction and SmILE, are increasingly being used.
authors.affiliation: From the Department of Refractive Surgery, Cleveland Clinic, OH.
authors.forename: Naveen
authors.initials: N
authors.lastname: Mysore
authors.forename: Ronald
authors.initials: R
authors.lastname: Krueger
mesh_terms: D001696:Biomechanical Phenomena; D003315:Cornea / Q000502:physiology; D019781:Corneal Topography; D006801:Humans; D007640:Keratoconus / Q000175:diagnosis / Q000601:surgery; D053685:Laser Therapy / Q000379:methods; D011183:Postoperative Complications; D011300:Preoperative Care; D012030:Refractive Errors / Q000175:diagnosis / Q000503:physiopathology; D054140:Refractive Surgical Procedures / Q000379:methods* / Q000639:trends