Review/UpdateCorneal biomechanics after laser refractive surgery: Unmasking differences between techniquesFernández, Joaquín MD, PhD; Rodríguez-Vallejo, Manuel PhD*; Martínez, Javier OD; Tauste, Ana PhD; Piñero, David P. PhD Author Information From the Department of Ophthalmology (Qvision) (Fernández, Rodríguez-Vallejo, Martínez, Tauste), Vithas Virgen del Mar Hospital and the Department of Ophthalmology (Fernández, Piñero), Torrecárdenas Hospital Complex, Almería, and the Department of Optics, Pharmacology and Anatomy (Piñero), University of Alicante, and the Department of Ophthalmology (Piñero), Vithas Medimar International Hospital, Alicante, Spain. *Corresponding author: Manuel Rodríguez-Vallejo, PhD, Department of Ophthalmology, Vithas Virgen del Mar Hospital, Carretera el Mami a Viator, km 1, 04120, Almería, Spain. E-mail: [email protected] Submitted June 15, 2017; revised October 2, 2017; accepted October 3, 2017.Figure: First author: Joaquín Fernández, MD, PhD Department of Ophthalmology, Vithas Virgen del Mar Hospital, Almería, SpainJournal of Cataract & Refractive Surgery: March 2018 - Volume 44 - Issue 3 - p 390-398 doi: 10.1016/j.jcrs.2017.10.054 Buy Metrics Abstract The hypothesis that small-incision lenticule extraction provides better preservation of corneal biomechanics than previous laser refractive techniques has led to a growth in the interest in clinical and experimental research in this field. This hypothesis is based on the fact that corneal layers with greater stiffness are preserved with this new technique. However, this hypothesis is controversial because clinical research has shown a great disparity in the outcomes. In this review, we performed an in-depth analysis of the factors that might affect corneal biomechanics in laser refractive surgery procedures from a macrostructural to a microstructural viewpoint. New advances in algorithms with current devices or the introduction of new devices might help unmask the possible advantages of small-incision lenticule extraction in corneal biomechanics. © 2018 by Lippincott Williams & Wilkins, Inc.