Refractive surgery has transformed modern ophthalmic practice, delivering life-changing visual outcomes to millions of patients worldwide. Yet as techniques have evolved — from microkeratome LASIK to femtosecond flaps, SMILE, refractive lens exchange and premium IOLs — the spectrum of potential complications has expanded in parallel. Management of Complications in Refractive Surgery, now in its third edition, arrives as a timely and authoritative resource for ophthalmologists navigating this increasingly complex landscape.
Edited by Jorge L. Alió, Dimitri T. Azar and Jorge L. Alió del Barrio, the book spans more than 500 pages and draws on the expertise of internationally recognised refractive surgeons. Its core message is clear: while refractive procedures are performed on otherwise healthy eyes, no refractive surgery is risk-free, and optimal outcomes depend on anticipating, recognizing and decisively managing any complications.
The book’s structure mirrors the clinical journey of refractive surgery. Early sections address intraoperative challenges in LASIK, femtosecond flap creation and SMILE — including suction loss, free flaps, lenticule remnants and interface problems — providing step-by-step guidance grounded in real-world surgical experience.
Later sections tackle postoperative complications that continue to trouble clinicians, such as epithelial ingrowth, diffuse lamellar keratitis, corneal ectasia, dry eye, night vision disturbances and irregular astigmatism. Particularly valuable is the detailed discussion of optical quality and higher-order aberrations, supported by wavefront analysis, corneal topography, and case-based illustrations that translate theory into practical decision-making.
One of the book’s defining strengths is its breadth. Refractive surgery is no longer limited to corneal laser procedures, and this edition reflects that reality. Dedicated sections explore complications related to corneal cross-linking, intracorneal ring segments, corneal inlays, refractive lens exchange, phakic IOLs, and premium IOL implantation.
There are also chapters on neuroadaptation failure, dysphotopsias, strabismus, and binocular vision disturbances, reminding readers that patient dissatisfaction often arises not from refractive error alone, but from complex neural and optical interactions. The inclusion of retinal and optic nerve complications further underscores the need for refractive surgeons to think beyond the anterior segment.
For ophthalmologists — whether refractive specialists or comprehensive clinicians — this book serves multiple roles. Firstly, it offers practical solutions for when complications inevitably arise, and acts as a decision-making guide, helping clinicians choose the right procedure for the right patient. Secondly, the book could be viewed as a medico-legal safeguard, emphasizing risk stratification, informed consent, and proper documentation in all procedures. Thirdly, it can be used by ophthalmologists as an educational resource, being suitable for both trainees and experienced surgeons alike.
Above all, Management of Complications in Refractive Surgery reinforces a crucial principle: excellence in refractive surgery is defined not only by achieving emmetropia, but by how effectively complications are prevented, recognized, and managed.
Edited by Jorge L. Alió, Dimitri T. Azar and Jorge L. Alió del Barrio, the book spans more than 500 pages and draws on the expertise of internationally recognised refractive surgeons. Its core message is clear: while refractive procedures are performed on otherwise healthy eyes, no refractive surgery is risk-free, and optimal outcomes depend on anticipating, recognizing and decisively managing any complications.
The book’s structure mirrors the clinical journey of refractive surgery. Early sections address intraoperative challenges in LASIK, femtosecond flap creation and SMILE — including suction loss, free flaps, lenticule remnants and interface problems — providing step-by-step guidance grounded in real-world surgical experience.
Later sections tackle postoperative complications that continue to trouble clinicians, such as epithelial ingrowth, diffuse lamellar keratitis, corneal ectasia, dry eye, night vision disturbances and irregular astigmatism. Particularly valuable is the detailed discussion of optical quality and higher-order aberrations, supported by wavefront analysis, corneal topography, and case-based illustrations that translate theory into practical decision-making.
One of the book’s defining strengths is its breadth. Refractive surgery is no longer limited to corneal laser procedures, and this edition reflects that reality. Dedicated sections explore complications related to corneal cross-linking, intracorneal ring segments, corneal inlays, refractive lens exchange, phakic IOLs, and premium IOL implantation.
There are also chapters on neuroadaptation failure, dysphotopsias, strabismus, and binocular vision disturbances, reminding readers that patient dissatisfaction often arises not from refractive error alone, but from complex neural and optical interactions. The inclusion of retinal and optic nerve complications further underscores the need for refractive surgeons to think beyond the anterior segment.
For ophthalmologists — whether refractive specialists or comprehensive clinicians — this book serves multiple roles. Firstly, it offers practical solutions for when complications inevitably arise, and acts as a decision-making guide, helping clinicians choose the right procedure for the right patient. Secondly, the book could be viewed as a medico-legal safeguard, emphasizing risk stratification, informed consent, and proper documentation in all procedures. Thirdly, it can be used by ophthalmologists as an educational resource, being suitable for both trainees and experienced surgeons alike.
Above all, Management of Complications in Refractive Surgery reinforces a crucial principle: excellence in refractive surgery is defined not only by achieving emmetropia, but by how effectively complications are prevented, recognized, and managed.
