Corneal refractive surgery, a widely adopted method for correcting refractive errors, has demonstrated its safety, efficacy, and predictability in extensive research. Studies indicate varying degrees of intraoperative fluctuations inintraocular pressure, potentially impacting the posterior segment structures and functions due to surgical techniques, equipment, technical proficiency, and patient-specific factors. Although short-term postoperative follow-up in most patients does not reveal visual dysfunction, the long-term effects and potential risks of transient high intraocular pressure during surgery on the posterior segment structures and functions remain unclear. Therefore, the assessment of posterior segment complications following corneal refractive surgery is of paramount importance in clinical practice. This review aims to explore the characteristics of intraocular pressure fluctuations during corneal refractive surgery and their effects on structures and functions of the vitreous, retina, and optic nerve in the posterior segment, analyze possible causes and risk factors, discuss their implications for current clinical treatment, and consider future trends, providing insights for clinical practice.