Prevalencia a 10 años del desprendimiento de retina regmatógeno en pacientes miopes intervenidos de cirugía refractiva con láser excimer o lente fáquica de cámara posterior

Laburpena

Myopia is the most frequent refractive defect, with a prevalence ranging from 30.6% on average in the European countries of our environment, to 47.2% in some Southeast Asian countries such as China or Singapore, and its most common cause is an excessive anterior-posterior diameter of the eyeball caused by genetic and environmental factors, there is a wide variability according to races and sociocultural level of the population. This anatomical disorder that gives rise to myopia is responsible for certain pathologies having a higher incidence in these patients. Among them the rhegmatogenous retinal detachment (RRD) that manifests itself as a detachment of the photoreceptor layer of the retina with respect to the pigment epithelium after a rupture of all the layers of the retina, usually produced by a traction on it due to the deterioration of the vitreous. Its incidence in myopic is 1.02%, 10 times higher than in the general population, between 0.1% and 0.3%. Refractive surgery in myopic eyes with its three main techniques photorefractive keratectomy (PRK), LASIK (laser in situ keratomileusis) and the implantation of phakic lenses (intraocular collamer lens or ICL), and its possible influence on the development of RRD, have been the subject of numerous studies and publications, many of them with cases occurring a few days after surgery. This added to possible etiopathogenic factors, such as laser shock waves on the cornea, the effect on intraocular pressure of the LASIK suction ring, and sudden pressure changes along with inflammation in the ICL have given rise to a possible causal relationship between the two. The purpose of this doctoral thesis is to know if refractive surgery in its three main variants for myopic patients poses an added risk, even in the long term, for the development of a rhegmatogenous retinal detachment, with a level of evidence higher than that of the studies published to date.