Dry eye after refractive surgery: a meta-analysis

Sambhi, Raman-Deep Singh; Sambhi, Gagan; Mather, Rookaya; Malvankar-Mehta, Monali S.

doi:10.1016/j.jcjo.2019.07.005

Cited by 63 publications

(37 citation statements)

References 12 publications

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“…In the treatment of myopia and myopic astigmatism, small-incision lenticule extraction (SMILE) has become an increasingly popular alternative to laser in situ keratomileusis (LASIK). The former offers on-par results concerning safety and efficacy 1 – 5 , and probably carries advantages regarding corneal biomechanics 6 , corneal wound healing 7 , and iatrogenic dry eye symptoms 8 , 9 .…”

Section: Introductionmentioning

confidence: 99%

“…In conclusion, non-inferior outcomes of SMILE can also be expected in eyes with steep (≥ 47D) or flat (< 42D) preoperative keratometry, while SMILE however induces more SA in eyes with a flat keratometry.In the treatment of myopia and myopic astigmatism, small-incision lenticule extraction (SMILE) has become an increasingly popular alternative to laser in situ keratomileusis (LASIK). The former offers on-par results concerning safety and efficacy 1-5 , and probably carries advantages regarding corneal biomechanics 6 , corneal wound healing 7 , and iatrogenic dry eye symptoms 8,9 .To treat myopia or myopic astigmatism, all keratorefractive procedures rely on the flattening of central corneal curvature to produce an "optical zone" with altered corneal power. in excimer-based keratorefractive surgery (LASIK and photorefractive keratometry; PRK), preoperative keratometry can influence postoperative refractive and visual outcomes, especially in extremely flat or steep keratometry, and even more so in conjunction with high myopic ablations [10][11][12][13] .…”

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confidence: 99%

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Impact of extreme (flat and steep) keratometry on the safety and efficacy of small incision lenticule extraction (SMILE)

Luft

Reinking

Mayer

et al. 2021

Sci Rep

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Little is known about the connection between preoperative keratometry and postoperative results of myopic small-incision lenticule extraction (SMILE). To determine the influence of extreme (flat and steep) corneal keratometry on the safety and efficacy of SMILE, the databases of the Department of Ophthalmology, Ludwig-Maximilians-University Munich, Germany, and SMILE Eyes Linz, Austria, were screened for patients with steep and flat keratometry who had undergone SMILE. In this cross-sectional matched comparative cohort study, eyes with markedly flat (< 42.0 diopters; D) or steep (≥ 47.0D) preoperative corneal keratometry were matched to a cohort of eyes with regular keratometry (42.0–46.9D) by preoperative manifest refractive spherical equivalent and cylinder, age, corrected distance visual acuity and surgical SMILE parameters. The standardized graphs and terms for refractive surgery results were applied to compare the three groups. Changes in higher order aberrations (HOAs) were evaluated on Scheimpflug imaging. In total, 63 eyes (21 each) of 54 patients with a mean refractive spherical equivalent of − 5.21 ± 1.59 D were followed up for a mean of 9.2 ± 6.1 (minimum ≥ 3) months. Mean baseline keratometry was 41.3 ± 0.7D (flat), 45.5 ± 1.0D (regular) and 47.7 ± 0.6D (steep) (p < 0.0001). Compared to the regular group, the flat and the steep cornea group resulted in a non-inferior percentage of eyes within ± 0.50 D of target refraction (p = 0.20), uncorrected distance visual acuity (p = 0.95) and corrected distance visual acuity (p = 0.20). Flat corneas however experienced a stronger induction of spherical aberration (SA) compared to the steep group (p = 0.0005). In conclusion, non-inferior outcomes of SMILE can also be expected in eyes with steep (≥ 47D) or flat (< 42D) preoperative keratometry, while SMILE however induces more SA in eyes with a flat keratometry.

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Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

Impact of extreme (flat and steep) keratometry on the safety and efficacy of small incision lenticule extraction (SMILE)

Luft

Reinking

Mayer

et al. 2021

Sci Rep

View full text Add to dashboard Cite

show abstract

“…Esta situación concuerda con la realidad en la clínica, pues LASIK es la técnica más común en todo el mundo. Otra explicación podría ser que LASIK produce una reducción significativa en la producción de lágrimas con respecto a otras técnicas de cirugía refractiva 30 .…”

Section: Discussionunclassified

Ojo seco y cirugía refractiva, estudio de red de citación

Fraga-Graells¹,

Álvarez-Peregrina²,

Villa-Collar³

et al. 2021

Revista Mexicana De Oftalmología

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Identificar las conexiones entre los investigadores más citados y el impacto de autores, revistas y contenidos en el campo de ojo seco tras cirugía refractiva, para focalizar la futura investigación en ello. Método: Se realizó una búsqueda de "ojo seco y cirugía refractiva" en Web of Science, y se limitó el campo para artículo, palabras clave y resumen, vinculados con "OR". El archivo resultante se analizó con el software CitNetExplorer® y se obtuvieron las publicaciones más citadas. Se realizó otro subanálisis sobre citaciones entre autores para identificar grupos y publicaciones principales. Resultados: Se hallaron 220 publicaciones entre 1997 y 2019 que generaron 675 citaciones en la red. Los 20 artículos más citados, encabezados por Hovanesain, et al., fueron publicados por Journal of Cataract and Refractive Surgery y Journal of Refractive Surgery. Mediante las funciones "cluster" y "core" se obtuvieron dos grupos y 106 artículos con al menos cuatro citas en la red, respectivamente. Conclusiones: Las técnicas actuales de cirugía refractiva son procedimientos avanzados y su complicación más frecuente es la aparición de ojo seco, que provoca insatisfacción y disminución de la calidad de vida de los pacientes. El ojo seco y la cirugía refractiva son un área destacada para los investigadores, con una cantidad significativa de publicaciones y conexiones entre ellos. Ampliar el conocimiento en este ámbito servirá para la mejora de aplicaciones clínicas con el fin de disminuir la aparición de ojo seco.

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“…Patients were selected on the basis of the following criteria: (1) able to provide written and signed informed consent; (2) had undergone previous LASIK surgery; (3) experiencing at least one of the following symptoms: dryness, burning, irritation, grittiness, foreign body sensation or fluctuating vision; (4) NITBUT B 5 s; (5) Ocular Surface Disease Index (OSDI) (Allergan, Inc., Irvine, CA) score C 13 [32]; (6) MGQ C 4 or MGEx C 1; (7) persistent symptoms of DE for 1 year of more following LASIK surgery. Participants with decreased best corrected visual acuity (BCVA) (\ 20/20), active infection, eye lid disorders and any other systemic diseases affecting blinking or the ocular surface, eyelid surgeries and hereditary corneal diseases were excluded form enrolling in this study.…”

Section: Inclusion and Exclusion Criteriamentioning

confidence: 99%

Management of Post-LASIK Dry Eye with Intense Pulsed Light in Combination with 0.1% Sodium Hyaluronate and Heated Eye Mask

Song

et al. 2021

Ophthalmol Ther

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Introduction Laser in situ keratomelieusis (LASIK) is one of the most frequently performed refractive treatments. Dry eye (DE) is common in patients after LASIK and can be bothersome postoperatively. Therapies such as intense pulsed light (IPL), sodium hyaluronate (SH) and heated eye mask (HEM) have been reported to improve signs and symptoms of DE . Aim The purpose of this prospective study was to evaluate and compare the effects of IPL and 0.1% SH (IPL group, 50 eyes) and IPL in combination with 0.1% SH and HEM (IPL + group, 50 eyes) in participants with persistent post-LASIK DE. Methods The final analysis included 100 patients (100 eyes) who had LASIK for myopic correction and had been experiencing moderate to severe DE following LASIK for over a year. Participants were randomly assigned to either the IPL group (2 IPL sessions) or IPL + group (2 IPL sessions and daily HEM for 4 weeks), and both groups continued the use of daily 0.1% SH (HYLO-COMOD®) preservative-free eye drops. Non-invasive tear break-up time (NITBUT), tear film lipid layer (TFLL), lower tear meniscus height (LTMH), meibomian gland quality (MGQ), meibomian gland expressibility (MGEx), corneal fluorescein staining (CFS), ocular surface disease index (OSDI) and artificial tear usage (ATU) survey were assessed at baseline (BL) and follow-up at 2 (F1) and 4 weeks (F2). Results Following the treatment protocol, all dry eye (DE) parameters assessed in this study improved significantly ( P < 0.05) in both groups at F2 compared with their respective BL measurements. Inter-group comparison at F2 found significant differences in their NITBUT (IPL: 6.06 ± 0.59 vs. IPL +: 6.67 ± 0.86, P < 0.001), TFLL (IPL: 1.90 ± 0.65 vs. IPL +: 1.60 ± 0.64, P = 0.021), LTMH (IPL: 0.186 ± 0.053 vs. 0.204 ± 0.034, P = 0.003), MGQ (IPL: 1.48 ± 0.54 vs. IPL +: 1.26 ± 0.56, P = 0.026), MGEx (IPL: 1.62 ± 0.53 vs. IPL +: 1.44 ± 0.50, P = 0.038) and OSDI (IPL: 32.54 ± 6.85 vs. IPL +: 29.76 ± 4.74, P = 0.001), while CFS score (IPL: 4.02 ± 0.65 vs. IPL +: 3.96 ± 0.73, P = 0.652) and ATU (IPL: 1.88 ± 0.63 vs. IPL +: 1.72 ± 0.50, P = 0.159) showed no significant difference. Conclusion Post-LASIK DE signs and symptoms can be improved by combining therapies such as IPL, HEM and 0.1% SH. Increased TFLL due to a combination of IPL, 0.1% SH and HEM had a greater positive impact on the subjective and objective DE measurements in participants with persistent post-LASIK DE.

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Dry eye after refractive surgery: a meta-analysis

Cited by 63 publications

References 12 publications

Impact of extreme (flat and steep) keratometry on the safety and efficacy of small incision lenticule extraction (SMILE)

Impact of extreme (flat and steep) keratometry on the safety and efficacy of small incision lenticule extraction (SMILE)

Ojo seco y cirugía refractiva, estudio de red de citación

Management of Post-LASIK Dry Eye with Intense Pulsed Light in Combination with 0.1% Sodium Hyaluronate and Heated Eye Mask

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