Refractive surgery is practiced worldwide on patients today and to offer it as an obligatory reference for the refractive surgeon, not only for the clinical and surgical practice but also for the academicapproach to the study of the complications of refractive surgical techniques including Premium IOLs.
The third edition of this book contains new chapters that cover the complications of new important surgical approaches, such as multifocal intraocular lenses, premium lenses, extended depth of field lenses, femtosecond laser, corneal surgery and others. In addition, chapters from the previous edition, which cover complications such as Intraoperative complications, e.g. intraocular refractive surgery, femtosecond laser, LASIK and KLEX, refractive lens exchange, corneal refractive surgery, early post-operative complications and late post-operative complications, were updated to ensure it contains the most current information.
This book provides ophthalmic surgeons and particularly refractive and cataract surgeons with appropriate solutions for the most frequent problems they would face in their daily practice.
Section 1: Complications of Corneal Refractive Surgery: LASIK
Intraoperative Complications.
Chapter
1. Thin, Irregular, and Buttonhole
Flaps.
Chapter
2. Intraoperative Flap Complications in LASIK: Prevention and
Management of Free Flaps.
Chapter
3. Management of the Distorted Flap.-
Section 2: Complications of Corneal Refractive Surgery: SMILE Intraoperative
Complications.- Chapter
4. Uncollaborative Patient and Suction Losses.-
Chapter
5. Lenticule Creation Complications: OBL, Black Spots and Treatment
Decentrations.
Chapter
6. Lenticule Extraction Complications: Retained
Fragments, Incision Tears, Cap Perforation, and False Dissection
Plane.- Section 3: Complications of Corneal Refractive Surgery: LASIK and
SMILE Postoperative Complications.
Chapter
7. Scarring.
Chapter
8.
Infections After Refractive Surgery.
Chapter
9. Diffuse Lamellar Keratitis
(DLK).
Chapter
10. Pressure-Induced Interlamellar Stromal Keratitis and
Persistent Epithelial Defect (PED) Masquerade Syndrome.
Chapter
11. Small
Incision Lenticule Extraction (SMILE) Complications.
Chapter
12. Prevention
and Management of Flap Striae After LASIK.
Chapter
13. Marginal Sterile
Corneal Infiltrates After LASIK and Corneal Procedures.
Chapter
14.
Melting.
Chapter
15. Dry Eye.
Chapter
16. Post-LASIK Corneal Dysesthesia.-
Chapter
17. Epithelial Ingrowth.
Chapter
18. Corneal Ectasia.
Chapter
19.
Ptosis.- Section 4: Complications of Corneal Refractive Surgery: Surface
Ablation Complications.
Chapter
20. Complications of Laser Epithelial
Keratomileusis (LASEK).
Chapter
21. Corneal Haze After Refractive Surgery.-
Section 5: Complications of Corneal Refractive Surgery: Refractive
Miscalculation.
Chapter
22. Refractive Miscalculation with Refractive
Surprise - Sphere.
Chapter
23. Astigmatism Surprise After Refractive
Surgery.- Section 6: Complications of Corneal Refractive Surgery: Optical
Aberrations and Corneal Irregularities.
Chapter
24. Causes of Higher-Order
Aberrations Induction in Excimer Laser and Femtosecond Surgery.
Chapter
25.
Night Vision Disturbances Following Refractive Surgery: Causes, Prevention,
and Treatment.
Chapter
26. Decentration.
Chapter
27. Corneal Irregularity
Following Refractive Surgery: Causes and Therapeutic Approaches.
Chapter
28.
Treatment of the Aberrated Cornea with Wavefront Guided Excimer Laser
Surgery.- Section 7: Complications of Corneal Refractive Surgery: Other
Corneal Refractive Surgical Procedures.
Chapter
29. Complications of Corneal
Collagen Cross-Linking.
Chapter
30. CXL for Post-LASIK Ectasia.
Chapter
31.
Complications for Refractive Keratotomy.
Chapter
32. Management
Complications of Intracorneal Ring Segment Implantation.
Chapter
33. Corneal
Inlays: Complications.
Chapter
34. EDOF and Multifocal Lenses.- Section 8:
Refractive Lens Exchange Complications.
Chapter
35. Complications of
Multifocal Intraocular Lenses.
Chapter
36. Refractive Surprise AfterCataract
Following Corneal Refractive Surgery.
Chapter
37. Refractive Lens Exchange
and Choroidal Neovascularization.
Chapter
38. Multifocal IOL and EDOF Lenses
Neuroadaptation Failure.
Chapter
39. Retinal Complications Following
Refractive Lens Exchange and Phakic IOL.- Section 9: Phakic Intraocular Lens
Complications.
Chapter
40. Complications of Anterior Chamber Angle-Supported
Phakic Intraocular Lenses.
Chapter
41. Complications of Iris-Supported
Phakic IOLs.
Chapter
42. Complications of Posterior Chamber Phakic IOLs.-
Chapter
43. Bilensectomy Procedures.- Section 10: Optic Nerve, Retina, and
Binocular Vision.
Chapter
44. Optic Neuropathy and Retinal Complications
After Corneal Refractive Surgery.
Chapter
45. Effect of Refractive Surgery
on Strabismus and Binocular Vision.
Chapter
46. Diplopia Following
Refractive Lens Exchange.
Chapter
47. Complications Related to Femtosecond
Laser-Assisted LAISK.- Section 11: Refractive Surgery Outcomes and Quality of
Life.
Chapter
48. Refractive Surgery Outcomes and Frequency of
Complications.
Chapter
49. Influence of Refractive Surgery Complications on
Quality of Life.
Chapter
50. Predicting the Unhappy Patient and Patient
Expectations.
Prof. Dr. Jorge Alio MD, PhD, FEBO, FWCRS is Professor and Chairman of Ophthalmology, University Miguel Hernandez, Alicante, Spain, founder of Vissum Miranza, Alicante, Spain and the Jorge Alió Foundation for the Prevention of Blindness. He is a high-volume surgeon in cataract, cornea and refractive surgery with over 60,000 surgeries performed. His main research interests include lens, refractive and corneal surgery. Pioneer in the area of multifocal, accommodative and toric IOLs, excimer laser refractive surgery, phakic IOLs and more recently corneal regeneration surgery. Author of over 835 peer review papers (ResearchGate), 444 chapters, 98 books and over 2876 communications in international congresses. 2025 Hirsch factor (h-factor) of 78 (Scopus). The Powerlist 2025, Top 10 in the category of Cataract and Refractive. The Ophthalmologist 2025. Named a 2024 Highly Ranked Scholar by ScholarGPS in the top 0.05% of all scholars worldwide in medicine and ranked nŗ 1 in Refractive surgery for lifetime accomplishments, nŗ 4 in Cataract and nŗ 7 in Intraocular lens.
LXIII chair of the Academia Ophthalmologica Internationalis, XLIX chair of the European Academy of Ophthalmology, President of the ISRS/AAO (2006-2008) member of the American Ophthalmological Society, he has been member of the Board of the European Society of Cataract and Refractive Surgeons and has received over 103 international and national awards including; the Miguel Hernandez University Award for Excellence in International Research 2023 and 2024 for being ranked in the worlds top 2% of scientists, as published by Elsevier (August 2024), the Charles McGhee Medal, British Society of Refractive Surgery (BSRS) (June 2024), the Binkhorst Medal Lecture ESCRS Vienna (September 2023), the IIIC Medal, ESCRS Vienna (September 2023), Premio Castroviejo de la Sociedad Espańola de Oftalmologia a la Trayectoria Profesional (2023),the Life Achievement Honor Award. AAO (2018, 2012), Presidential Award of the ISRS/AAO (2015), ISRS/AAO José Barraquer Lecture and Award, Congress of the AAO/ISRS, San Francisco (USA), (2009), Senior Achievement Award. AAO (2008). He is the creator and Director of the online International Specialization Course in Refractive, Cornea and Lens Surgery (University Miguel Hernandez). Fellows from all over the world come to his research facilities to be trained under his supervision.
Dimitri Azar, MD, MBA is the Chief Executive Officer of Twenty/Twenty Therapeutics, a joint venture established by Google/Verily and Santen. He is Distinguished Professor and BA Field chair of ophthalmic research and Executive Dean Emeritus at the University of Illinois College of Medicine, where he pioneered the convergence of engineering and data science/artificial intelligence with basic and clinical medicine. Dimitri sits on the board of the Tear Film and Ocular Surface Society, the board of the Himalayan Cataract Project and the Verily SAB board. He also served as a non-executive director on the Boards of Novartis (2012-2019) and Verb Surgical (2015-2019). He completed his residency and fellowship training at the Massachusetts Eye and Ear Infirmary, Harvard Medical School.
He then moved to the Johns Hopkins Wilmer Ophthalmological Institute as assistant professor and founding director of the refractive surgery service (1991-1996). He returned to the Mass Eye and Ear Infirmary as the Director of the Cornea, Refractive Surgery and Contact lens Services (1996-2006). He was named tenured Professor of Ophthalmology at Harvard Medical School (2003-2006) and senior scientist at the Schepens Eye Research Institute, before joining the University of Illinois as Head of the Ophthalmology Department (2006-2011), and later as Executive Dean (2011-2018). He is an internationally recognized ophthalmic surgeon and a leader in basic science, corneal wound healing, angiogenesis, and clinically related vision research, making significant contributions to the treatment of corneal and anterior segment diseases and to advances in refractive surgery through mathematical analyses and applications of advanced optics. His basic science research on matrix metalloproteinases in corneal wound healing and angiogenesis was continually funded by the National Eye Institute R01 award between 1993 and 2021. Dr. Azar received his MD from American University of Beirut and his MBA (with high distinction) from University of Chicago, Booth School of Business. He also holds an honorary doctoral degree from the University of Balamand, as well as an honorary master's degree from Harvard. Dr. Azar is the author of more than 500 scientific articles and book chapters. He is the editor of 23 books in ophthalmology and holds more than 76 patents in ophthalmic pharmacology and bioengineering. He was named one of The Best Doctors in America and recognized among Castle Connollys Regional Top Doctors in America annually between 1994 and 2020. He is a member of the Beta Gamma Sigma Honor Society and has served as Trustee for the Chicago Medical Society and for the Association of Research and Vision in Ophthalmology, and President of the Chicago Ophthalmological Society. Dr. Azar has received numerous named lectures and leadership awards, including the Life Achievement award by the American Academy of Ophthalmology, the Lans Distinguished Award, the Castroviejo Award, and the University of Illinois at Chicago Scholar Award and Distinguished Professor Award.
Jorge L. Alió del Barrio MD, PhD, FEBOS-CR, FWCRS
Jorge L. Alió del Barrio graduated in Medicine and Surgery from the Universidad Autónoma de Madrid. Specialized in Ophthalmology at the University Hospital of Ramón y Cajal (Madrid, 2009-2013), and he subspecialized in the area of Cornea, Cataract, Ocular Surface and Refractive Surgery after completing Fellowships at Guy`s and St Thomas' Hospital (2013-2014, London, UK) and Moorfields Eye Hospital (2014-2015, London, UK). PhD by the University of Alcalį de Henares (Madrid), he is currently working as a cornea, cataract, ocular surface and refractive surgery surgeon at Vissum (Miranza Group) in Alicante, Spain. He is also Associate Professor in the Department of Ophthalmology in the Faculty of Medicine of the Universidad Miguel Hernįndez in Alicante. More than 160 publications in prestigious peer reviewed journals and international scientific books support his research and scientific background. Graduated as "Fellow of the European Board of Ophthalmology-Specialist Diploma in Cataract and Refractive Surgery (FEBOS-CR)" from September 2018 and later awarded (2022) by the Spanish Society of Ophthalmology with the Premio Arruga to the best CV of a Spanish ophthalmologists under 40 years of age. Declared as Top reviewer by the Journal of Refractive Surgery in 2021, 2022, 2023 and 2024 and finally declared as Fellow of the World College of Refractive Surgeons & Visual Sciences (FWCRS) from June 2023".
