Behera RK, Gupta PC, Morya AK, Khullar S. Safety and efficacy of keratorefractive surgery in diabetes mellitus: A clinical review. World J Clin Cases 2026; 14(4): 118154 [DOI: 10.12998/wjcc.v14.i4.118154]
Corresponding Author of This Article
Arvind Kumar Morya, Additional Professor, Consultant, Principal Investigator, Senior Researcher, Department of Ophthalmology, All India Institute of Medical Sciences, Bibi Nagar, Hyderabad 508126, Telangana, India. bulbul.morya@gmail.com
Research Domain of This Article
Ophthalmology
Article-Type of This Article
Minireviews
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Feb 6, 2026 (publication date) through Feb 11, 2026
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Journal Information of This Article
Publication Name
World Journal of Clinical Cases
ISSN
2307-8960
Publisher of This Article
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Behera RK, Gupta PC, Morya AK, Khullar S. Safety and efficacy of keratorefractive surgery in diabetes mellitus: A clinical review. World J Clin Cases 2026; 14(4): 118154 [DOI: 10.12998/wjcc.v14.i4.118154]
Ranjan Kumar Behera, Parul Chawla Gupta, Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
Arvind Kumar Morya, Department of Ophthalmology, All India Institute of Medical Sciences, Hyderabad 508126, Telangana, India
Srishti Khullar, Department of Ophthalmology, Military Hospital, Agra 282001, Uttar Pradesh, India
Co-first authors: Ranjan Kumar Behera and Parul Chawla Gupta.
Author contributions: Behera RK and Gupta PC have made crucial and indispensable contributions towards the completion of the project as co-first authors; Behera RK, Gupta PC and Morya AK wrote the manuscript; Gupta PC and Morya AK edited the manuscript; Morya AK and Khullar S did the literature search; all of the authors read and approved the final version of the manuscript to be published.
Conflict-of-interest statement: All authors declare no conflict of interest in publishing the manuscript.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Arvind Kumar Morya, Additional Professor, Consultant, Principal Investigator, Senior Researcher, Department of Ophthalmology, All India Institute of Medical Sciences, Bibi Nagar, Hyderabad 508126, Telangana, India. bulbul.morya@gmail.com
Received: December 25, 2025 Revised: January 8, 2026 Accepted: January 19, 2026 Published online: February 6, 2026 Processing time: 42 Days and 18.1 Hours
Abstract
Keratorefractive surgery is typically performed to correct refractive errors, resulting in good postoperative outcomes. Certain conditions, such as autoimmune diseases, metabolic diseases like diabetes mellitus (DM), and the use of some drugs, may be absolutely or relatively contraindicated for refractive surgery. DM is a multisystemic disorder affecting various organs and can result in retinopathy, nephropathy, and neuropathy. Persistent hyperglycemia leads to various pathophysiological changes that can alter the biomechanical profile and the wound healing process of the cornea. Proper patient counselling, optimizing blood glucose levels, and frequent follow-up visits to monitor and manage potential complications, such as dry eye, non-healing epithelial defects, and neurotrophic keratitis, are essential for refractive surgeons. Laser-assisted in situ keratomileusis is preferred over photorefractive keratectomy due to its faster healing process. Cataract surgery in people with diabetes warrants various preoperative, intraoperative, and postoperative considerations for the best visual outcomes. This review focuses on the current evidence pertaining to various structural and functional corneal changes occurring in diabetics and their impact on keratorefractive procedures, thus providing a unified, clinically oriented framework to guide refractive surgeons in risk stratification, procedure selection, and postoperative management in patients with DM.
Core Tip: Although routinely performed, keratorefractive surgeries pose challenges, especially in diabetics. Diabetes mellitus can result in keratopathy and affect the corneal healing process, which puts refractive surgeons in a dilemma over whether to go ahead with the surgery or not. Although a relative contraindication, refractive surgeries can be performed on diabetics with proper glycemic control and strict postoperative monitoring. Various drugs and molecules are efficacious in cases of diabetic keratopathy.
