Faculty Opinions recommendation of Topical cyclosporine a treatment in corneal refractive surgery and patients with dry eye.

Modern corneal refractive surgery provides high efficiency, safety, predictability and stability of the different ametropia kinds correction’s clinically-functional results. However, in overwhelming percentage of cases, having spent some time after surgery patients complain about discomfort, eyes dryness, burning, feel gritty, redness, blurred and vision instability. Complaints mentioned above are caused by the appearance of transitory dry eye syndrome. Main etiology and pathogenesis factors of this disease are presented in this review. The results of dry eye syndrome classical diagnosis methods have been analyzed, as well as modern techniques, characterized by high specificity and sensitivity, which allow to increase the dry eye’s diagnostics accuracy. The study of the dry syndrome after corneal refractive surgery is devoted to a huge number of works of domestic and foreign authors. However, at present time there is no unique algorithm for assessing the damage of the ocular surface before and after corneal refractive surgery, which would include a set of high-precision and specific techniques for quickly and reliably evaluate the severity of dry eye syndrome, allowing to develop preventive measures and pathogenetically oriented treatment and, thereby, accelerate rehabilitation of patients after surgery. Research continuation is needed in this direction.

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Corneal refractive surgery-related dry eye: risk factors and management

Expert Review of Ophthalmology ◽

10.1586/17469899.2013.851602 ◽

2013 ◽

Vol 8 (6) ◽

pp. 561-575 ◽

Cited By ~ 1

Author(s):

Louis Tong ◽

Yang Zhao ◽

Ryan Lee

Keyword(s):

Risk Factors ◽

Dry Eye ◽

Refractive Surgery ◽

Corneal Refractive Surgery

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Evaluation of preoperative dry eye in people undergoing corneal refractive surgery to correct myopia

International Journal of Ophthalmology ◽

10.18240/ijo.2021.07.13 ◽

2021 ◽

Vol 14 (7) ◽

pp. 1047-1051

Author(s):

Peng-Fei Zhao ◽

◽

Ya-Bin Hu ◽

Kai Cao ◽

Ying Qi ◽

...

Keyword(s):

Influencing Factors ◽

Dry Eye ◽

Refractive Surgery ◽

Corneal Thickness ◽

Tear Film ◽

Corneal Curvature ◽

Related Factors ◽

History Of ◽

Corneal Refractive Surgery ◽

Male Patients

AIM: To investigate the incidence of preoperative dry eye and related factors in patients undergoing corneal refractive surgery to correct myopia. METHODS: A total of 141 patients with myopia who underwent corneal refractive surgery were surveyed by questionnaires, tear film break-up time (BUT) test, Schimer I test (SIt), corneal fluorescein staining (FL) test and diagnosed according to the currently recognized domestic diagnostic criteria for dry eye. Correlation analysis of factors such as age, gender, regular wearing of contact lens (CL), diopter (spherical equivalent), corneal thickness, and corneal curvature that may affect the onset of dry eye was carried out to clarify the main influencing factors. RESULTS: There were 64 patients (45.39%) diagnosed with dry eye. The male patients (20.31%) was significantly less than that of non-dry eye subjects (41.56%; χ2=7.260, P=0.007); the proportion of patients with dry eye wearing CL (81.25%) was significantly higher than that of non-dry eye subjects (51.95%; χ2=13.234, P<0.001); the median diopter level of dry eye patients was -6.59 (IQR: -8.87, -4.58) D, and the median diopter level of non-dry eye subjects was -5.69 (IQR: -7.15, -4.03) D. The diopter level of dry eye patients was significantly higher (Z=-2.086, P=0.019). However, the age, best corrected visual acuity, and intraocular pressure of dry eye patients were not statistically different from those of non-dry eye subjects (t=-0.257, -0.383 and 0.778, P=0.798, 0.702, and 0.438); the corneal thickness and corneal curvature (K1 and K2) were also not statistically different either (Z=-1.487, -1.036 and -1.707, P=0.137, 0.300, and 0.088). The research further analyzes the three significant factors in the single factor analysis (gender, CL wear, and diopter) in a multi-factor way: CL wear and diopter were the influencing factors of dry eye disease. Among them, CL wear increased the risk of dry eye by 2.934 times compared with no CL wear; for every 1 D increase in diopter, the risk of dry eye increased by 0.761 times. CONCLUSION: Preoperative dry eye is relatively common in patients who undergo corneal refractive surgery to correct myopia, especially in patients who have a history of CL wear and a high diopter level before surgery. Therefore, it is necessary to carry out preoperative screening and timely treatment of dry eye to obtain the best treatment outcome and postoperative satisfaction.

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Effects of Warm Compress on Tear Film, Blink Pattern and Meibomian Gland Function in Dry Eyes After Corneal Refractive Surgery

10.21203/rs.3.rs-288555/v1 ◽

2021 ◽

Author(s):

Xueyi Zhou ◽

Yang Shen ◽

Jianmin Shang ◽

Xingtao Zhou

Keyword(s):

Dry Eye ◽

Refractive Surgery ◽

Corneal Thickness ◽

Tear Film ◽

Meibomian Gland ◽

Blink Rate ◽

Lipid Layer ◽

Mean Values ◽

Corneal Refractive Surgery ◽

Gland Function

Abstract Background To assess the effects of warm compress (WC) on tear film lipid layer, blink pattern and Meibomian gland function in patients with dry eye following femtosecond laser small incision lenticule extraction (SMILE) and laser-assisted subepithelial keratomileusis (LASEK). Methods We enrolled 37 eyes of 37 participants, each with dry eye for more than 2 years following SMILE (25 eyes) or LASEK (12 eyes). WC was performed using a spontaneously heating eye mask. Safety parameters and effectiveness parameters (tear film break-up time, TBUT; tear film lipid layer thickness, TFLLT; blink pattern, and Meibomian secretory function scores, MGS) were assessed before and after WC. Results After WC, the following mean values all increased relative to baselines: central corneal thickness, spherical equivalent, minimum (Min-), maximum (Max-) and average (Ave-) TFLLT, TBUT, total MGS (TMGS), number of glands secreting any liquid (MGL), and complete blink rate (CBR) (p values ranging from < 0.0001 to 0.042). Partial blink frequency (PBF) and partial blink rate (PBR) decreased (p = 0.002 in both cases). The decrease of PBF was higher in SMILE subgroup than in LASEK (p = 0.030). TBUT variation was positively correlated with that of Ave-TFLLT and TMGS (p = 0.046, 0.028, respectively). Max-TFLLT variation was correlated with that of TMGS (p = 0.020). Conclusions WC may temporarily improve tear film quality and blink pattern, augment Meibomian gland function, and relieve dry eye symptoms after corneal refractive surgery, particularly that using the SMILE technique.

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Sjogren Syndrome and Dry Eye: The Impact of Corneal Refractive Surgery

Cornea ◽

10.1097/ico.0b013e3181d00a73 ◽

2010 ◽

Vol 29 (9) ◽

pp. 1072 ◽

Cited By ~ 1

Author(s):

Patrick M K Tam ◽

Alvin L Young ◽

Philip T H Lam

Keyword(s):

Dry Eye ◽

Refractive Surgery ◽

Sjögren Syndrome ◽

Sjogren Syndrome ◽

Corneal Refractive Surgery ◽

The Impact

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Effect of Rebamipide Ophthalmic Suspension on Intraocular Light Scattering for Dry Eye After Corneal Refractive Surgery

Cornea ◽

10.1097/ico.0000000000000456 ◽

2015 ◽

Vol 34 (8) ◽

pp. 895-900 ◽

Cited By ~ 12

Author(s):

Akihito Igarashi ◽

Kazutaka Kamiya ◽

Hidenaga Kobashi ◽

Kimiya Shimizu

Keyword(s):

Light Scattering ◽

Dry Eye ◽

Refractive Surgery ◽

Corneal Refractive Surgery ◽

Ophthalmic Suspension

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Ocular surface treatment in dry eye patients before corneal refractive surgery

Clinical ophthalmology ◽

10.32364/2311-7729-2020-20-4-180-186 ◽

2020 ◽

Vol 20 (4) ◽

pp. 180-186

Author(s):

O.A. Klokova ◽

◽

R.O. Damashauskas ◽

M.S. Geidenrich ◽

◽

...

Keyword(s):

Surface Treatment ◽

Dry Eye ◽

Ocular Surface ◽

Refractive Surgery ◽

Patient Survey ◽

Dry Eye Disease ◽

Eye Disease ◽

Eye Surgery ◽

Punctal Plugs ◽

Corneal Refractive Surgery

Aim: to analyze the prevalence of dry eye disease (DED) among adult patients with ametropias and the efficacy of its complex treatment when preparing the ocular surface for corneal refractive surgery.Patients and Methods: 1,762 patients with ametropias were examined. In addition to all of the standard eye checks, vital conjunctival and corneal staining, Scheimpflug corneal topography, and anterior segment OCT as well as patient survey were performed. Standard preservative-free tear substitutes with or without a short course of steroids, lubricants, 0.05% anionic cyclosporine emulsion (twice daily), and long-term punctal plugs were prescribed for DED.Results: mild DED was diagnosed in 1,021 patients (57.9%). Of them, corneal lesion was reported in 362 patients (35.4%) and asymptomatic DED in 250 patients (25.5%). Corneal topographic indices of one or both eyes were abnormal (as a result of DED) in 147 patients (14.4%). Significant (p≤0.05) increase in corneal epithelial thickness of one or both eyes was reported in 564 patients (55.2%). Ocular surface treatment in DED patients allowed for uncomplicated corneal refractive procedures while target refraction was achieved in 1,006 patients (98.5%). Conclusion: a complex diagnostic approach to DED involving specific tests, patient survey, corneal topography, and OCT provides the diagnosis of both manifest and latent DED. Combined treatment for conjunctival and corneal xerosis that includes tear substitutes, topical cyclosporine, and punctal plugs, improves ocular surface health in DED thus enlarging the list of indications and the safety of laser eye surgery in these patients.Keywords: dry eye disease, laser eye surgery, corneal refractive procedures, anionic cyclosporine emulsion, punctal plugs, corneal epithelium.For citation: Klokova O.A., Damashauskas R.O., Geidenrich M.S. Ocular surface treatment in dry eye patients before corneal refractive surgery. Russian Journal of Clinical Ophthalmology. 2020;20(4):180–186. DOI: 10.32364/2311-7729-2020-20-4-180-186.

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Effect of corneal refractive surgery on accommodative and binocular dysfunctions among civilian pilots in Southwest China

BMC Ophthalmology ◽

10.1186/s12886-021-01855-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Ye Wu ◽

Zhen Zhang ◽

Meng Liao ◽

Qi Li ◽

Xue Lin Tang ◽

...

Keyword(s):

Binocular Vision ◽

Refractive Surgery ◽

Visual Symptom ◽

Chi Square ◽

Visual Symptoms ◽

Significant Difference ◽

Symptom Scores ◽

Chi Square Test ◽

Corneal Refractive Surgery ◽

Normal Binocular Vision

Abstract Background To analyze whether corneal refractive surgery (CRS) is associated with the distribution of different accommodative dysfunctions (ADs) and binocular dysfunctions (BDs) in civilian pilots. A further aim was to analyze the percentages and visual symptoms associated with ADs and/or BDs in this population. Methods One hundred and eight civilian pilots who underwent CRS from January 2001 to July 2012 (age: 30.33 ± 4.60 years) were enrolled, the mean preoperative SE was − 1.51 ± 1.15 D (range: − 1.00- − 5.00 D). Ninety-nine emmetropic civilian pilots (age: 29.64 ± 3.77 years) who were age- and sex-matched to the CRS group were also enrolled. Refractive status, accommodative and binocular tests of each subject were performed. Visually related symptoms were quantified using the 19-item College of Optometrists in Vision Development Quality of Life (COVD-QOL) questionnaire. The 19 items were summed to obtain visual symptom scores that might indicate visual dysfunctions. The chi-square test was used to analyze differences in percentages of ADs and/or BDs between the CRS and emmetropic groups. The Mann-Whitney U test was used to compare visual symptom scores between pilots with ADs and/or BDs and pilots with normal binocular vision. Results No significant difference was observed between the CRS and emmetropic groups in the overall prevalence of ADs and BDs (15.7% and 15.2% in the CRS and emmetropic groups, respectively; P = 0.185). ADs were present in 4.63% and 3.03% of the CRS and emmetropic group, respectively. BDs were observed in 11.1% and 12.1% of the CRS and emmetropic group, respectively, yielding no significant differences between the groups in the prevalence of ADs or BDs (AD: P = 0.094; BD: P = 0.105). Pilots with ADs and/or BDs had significantly more visual symptoms than pilots with normal binocular vision (p < 0.001). Conclusions CRS for civilian pilots with low-moderate myopia might not impact binocular functions. ADs and/or BDs commonly occur in both emmetropia pilots and pilots who undergo CRS, and pilots with ADs and/or BDs are associated with increased symptoms. This study confirms the importance of a full assessment of binocular visual functions in detecting and remedying these dysfunctions in this specific population.

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Constitutive Laws for Biomechanical Modeling of Refractive Surgery

Journal of Biomechanical Engineering ◽

10.1115/1.2796033 ◽

1996 ◽

Vol 118 (4) ◽

pp. 473-481 ◽

Cited By ~ 122

Author(s):

Michael R. Bryant ◽

Peter J. McDonnell

Keyword(s):

Finite Element ◽

Material Properties ◽

Refractive Surgery ◽

Fiber Optic ◽

Transverse Isotropy ◽

Constitutive Laws ◽

Finite Element Models ◽

Corneal Refractive Surgery ◽

Best Fit ◽

Membrane Inflation

Membrane inflation tests were performed on fresh, intact human corneas using a fiber optic displacement probe to measure the apical displacements. Finite element models of each test were used to identify the material properties for four different constitutive laws commonly used to model corneal refractive surgery. Finite element models of radial keratotomy using the different best-fit constitutive laws were then compared. The results suggest that the nonlinearity in the response of the cornea is material rather than geometric, and that material nonlinearity is important for modeling refractive surgery. It was also found that linear transverse isotropy is incapable of representing the anisotropy that has been experimentally measured by others, and that a hyperelastic law is not suitable for modeling the stiffening response of the cornea.

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