Fundus Evaluation in Myopia: Essential for Pre- and Post-refractive Surgery

Objective To evaluate fundus conditions and analyze ocular examination parameters among myopic patients before and after refractive surgery. Methods This retrospective study enrolled 116 patients (144 eyes) divided into three groups: normal retina (normal group), retinal lesion not requiring treatment (untreated group) and retinal lesion requiring treatment (treated group). The treated group received preventive treatment for retinal diseases before refractive surgery. Demographic information, visual acuity, refraction, intraocular pressure (IOP), axis length (Axl), pupil diameter (PD), corneal tomography, and fundus images were collected and compared pre-operatively and post-operatively at 1 day, 6 months and 12 months. Results The treated group exhibited significantly higher pre-operative Axl and SE value compared to the other groups (P < 0.05). This group also displayed the most severe retinal diseases, with 52.5% presenting retinal holes or tears and 47.5% exhibiting lattice degeneration. SMILE surgery was performed in 78% of the normal group, 50% of the untreated group and 32.5% of the treated group. Postoperatively, all three groups demonstrated positive surgical outcomes with stable retinal conditions, and no new retinal holes or detachments during follow-ups. Conclusions Higher myopia and longer axial lengths increased retinopathy risk. Detailed preoperative fundus exams, long-term follow-ups and prophylactic treatment before surgery are essential.