Phenotypic characterization of patients developing chronic dry eye and pain after refractive surgery: A cross-sectional study

Vázquez, Amanda; Martínez-Plaza, Elena; Fernández, Itziar; Sobas, Eva M.; González-García, María J.; Salamanca, Andrés Bordalí; Ortega, Enrique; López-Miguel, Alberto; Calonge, Margarita

doi:10.1016/j.jtos.2022.07.010

Cited by 6 publications

(13 citation statements)

References 71 publications

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“…Female patients are at an increased risk[ 4 , 24 , 37 , 41 ] and have greater odds of developing more severe and chronic symptoms. [ 37 , 43 ] Older age has been reported as a risk factor by some authors[ 24 , 41 ] while others found no such association[ 4 , 21 , 37 , 39 ] Asian patients are at greater risk for developing chronic dry eye post-LASIK as compared with Caucasians. [ 44 ] Contact lens users also have a higher risk of developing postrefractive surgery dry eye.…”

Section: Predisposing Factorsmentioning

confidence: 99%

“…Patients may present with symptoms such as ocular dryness, pain, stinging, photophobia, redness, and visual fatigue. [ 5 , 22 , 43 , 58 ] Complaints of fluctuating vision and impaired functional vision due to irregular astigmatism induced by an unstable tear film are not uncommon. [ 65 ] The intensity and duration of these symptoms are highly variable due to the complex, multifactorial etiology with an often poor correlation between subjective symptoms and objective signs.…”

Section: Clinical Manifestationsmentioning

confidence: 99%

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Refractive surgery and dry eye - An update

Nair

Kaur

Sharma

et al. 2023

Indian Journal of Ophthalmology

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Dry eye disease is the most common complication and a frequent cause of patient dissatisfaction after corneal laser refractive surgery, which includes laser-assisted in situ keratomileusis (LASIK), small-incision lenticule extraction (SMILE), and photorefractive keratectomy (PRK). It has a complex, multifactorial etiology and is characterized by a highly variable clinical presentation. A detailed preoperative screening and optimization of the ocular surface prior to refractive surgery are the key to minimizing the incidence and severity of postoperative dry eye. Diagnosis of postrefractive surgery dry eye remains a challenge as no single symptom or clinical parameter is confirmative of the condition, and the symptoms and signs may not correlate well in many cases. A thorough understanding of the pathomechanism of the disease and its manifestations is essential to facilitate a treatment approach that is individualized for each patient. This article reviews various aspects of postrefractive surgery dry eye including its epidemiology, etiopathogenesis, risk factors, diagnosis, and management.

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Section: Predisposing Factorsmentioning

confidence: 99%

Section: Clinical Manifestationsmentioning

confidence: 99%

Refractive surgery and dry eye - An update

Nair

Kaur

Sharma

et al. 2023

Indian Journal of Ophthalmology

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“…), а также психоэмоциональное состояние пациента. Это позволит избежать развития тяжелых форм ССГ в послеоперационном периоде [21].…”

Section: клинический примерunclassified

The Role of Anamnesis in Modern Ophthalmic Practice: a Clinical Case

et al. 2023

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Eyes’ dryness continues to be the most frequent complication after LASIK. As a rule, it disappear in the vast majority of patients during the first year after surgery. The conducted studies indicate that complaints of eyes’ dryness in the preoperative period significantly increase the risk of developing a severe form of dry eye syndrome in the postoperative period, especially in middle-aged women (45–59 years) and older. The clinical case presented in this article indicates the development of a severe form of dry eye syndrome after LASIK in a middle-aged patient receiving hormone replacement therapy for menopause, complaining of a feeling of dryness and discomfort in the eyes in the preoperative period, with intolerance to contact lenses and taking antidepressants in the absence of signs of severe dry eye in the preoperative period. Consequently, surgical intervention led to the development of the mentioned above condition. It is confirmed by the literature data indicating that the above factors can cause the development of a severe form of dry eye syndrome after LASIK. Taking into account the fact that tear production tests do not always correlate with the intensity of complaints of dryness, burning sensation, pain in the eyes, the most important component at the stage of deciding on the feasibility of refractive surgery in a particular patient is the collection of anamnesis and clinical picture. When preparing patients with a history of dry eye syndrome for refractive surgery, it is necessary to inform them that they have a significantly increased risk of developing dry eye syndrome. It may persist in the long-term postoperative period, and possibly go into a chronic form. Candidates for refractive surgery in the presence of complaints characteristic of dry eye syndrome can only be those patients who respond well to therapy aimed at relieving these symptoms in the preoperative period. Taking into account the multicomponent nature of pain in dry eye syndrome — nociceptive pain, which is formed at the stage of receptor irritation in the corneal tissue, and neuropathic pain that occurs with the participation of the peripheral and central nervous system, a comprehensive approach is needed in the treatment of dry eye syndrome.

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“…8,9 Thus, it is speculated that dry eye after corneal refractive surgery may have a negative impact on the visual quality and threaten the patient’ s daily life quality, inducing physiological and psychological problems. 10…”

mentioning

confidence: 99%

“…8,9 Thus, it is speculated that dry eye after corneal refractive surgery may have a negative impact on the visual quality and threaten the patient' s daily life quality, inducing physiological and psychological problems. 10 Classical treatment against refractive surgery-related dry eye is the administration of artificial tears. With the progression of corneal nerve regeneration and corneal tissue recovery, most symptoms relieve and abnormal parameters of dry eye recover to normal levels in 6 months, including Schirmer test I (Schirmer I), BUT, and corneal fluorescein staining score.…”

mentioning

confidence: 99%

Effect of 3% Diquafosol Sodium on Dry Eye After Femtosecond Laser-Assisted In Situ Keratomileusis and Small Incision Lenticule Extraction Surgery in High-Myopic Eyes

Gao,

Lv,

Zhang

et al. 2023

Eye &Amp; Contact Lens: Science &Amp; Clinical Practice

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Purpose: To evaluate the effect of 3% diquafosol sodium eye drop on dry eye after femtosecond laser-assisted in situ keratomileusis (FS-LASIK) and small incision lenticule extraction (SMILE) in high-myopic eyes. Methods: Eighty-one cases with high myopia (162 eyes) who received FS-LASIK or SMILE were divided into four groups by surgical design and tear film stability: D-FS-LASIK (5s <breakup time [BUT] <10s) and D-SMILE (5s <BUT <10s) were treated with 3% diquafosol sodium and 0.3% sodium hyaluronate eye drops, C-FS-LASIK and C-SMILE (BUT ≥10s) treated with 0.3% sodium hyaluronate. Follow-up points were performed preoperatively and at 1 week, 1 month, and 3 months postoperatively. Schirmer I test, BUT, fluorescein staining, and objective optical quality were measured, and questionnaires were acquired. Results: The D-SMILE group showed increase in BUT postoperatively (1m: P=0.006, 3m: P=0.004), whereas C-FS-LASIK (1m: P=0.012) and C-SMILE (1m: P=0.036) groups showed decrease in BUT. Higher ΔBUT were observed in D-FS-LASIK (1m: P=0.027) and D-SMILE (1m: P=0.001, 3m: P=0.012) postoperatively. The D-FS-LASIK group showed less decrease than C-FS-LASIK group in Schirmer I. The D-SMILE group showed increase in Schirmer I, whereas C-SMILE showed decrease in 3 months. ΔOSDI was lower in D-SMILE group than in C-SMILE group (1m: P=0.026, 3m: P=0.035). Fatigue was severer in D-SMILE group than in C-SMILE group preoperatively (P=0.019), although there was no significant difference postoperatively. Objective scattering index (1m: P=0.002, 3m: P=0.021) and tear film objective scattering index (1m: P=0.005, 3m: P=0.010) were lower in D-FS-LASIK group than in C-FS-LASIK group postoperatively. The D-FS-LASIK group showed better VA20% (P=0.036) and VA9% (P=0.027) than the C-FS-LASIK group 1 month postoperatively. Conclusions: 3% Diquafosol sodium eye drop was effective for SMILE and FS-LASIK–related dry eye in high-myopic eyes. It is necessary to focus on perioperative anti–dry eye management and especially pay attention to the eyes with risk factors, including unstable tear film, high myopia, and FS-LASIK surgery.

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Phenotypic characterization of patients developing chronic dry eye and pain after refractive surgery: A cross-sectional study

Cited by 6 publications

References 71 publications

Refractive surgery and dry eye - An update

Refractive surgery and dry eye - An update

The Role of Anamnesis in Modern Ophthalmic Practice: a Clinical Case

Effect of 3% Diquafosol Sodium on Dry Eye After Femtosecond Laser-Assisted In Situ Keratomileusis and Small Incision Lenticule Extraction Surgery in High-Myopic Eyes

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