Impact of Dry Eye Disease on the Uncorrected Distance Visual Acuity After Small Incision Lenticule Extraction

Overview

Journal J Clin Med

Specialty General Medicine

Date 2023 Oct 14

PMID 37834823

Authors

Yan Shen

Jiajia Wang

Xingtao Zhou

Zhiqiang Yu

Jiaxu Hong

Qihua Le

Affiliations

Soon will be listed here.

Abstract

The aim of this study was to explore the impact of dry eye disease (DED) on the uncorrected distance visual acuity (UDVA) and refractive status after small incision lenticule extraction (SMILE). This prospective cohort study enrolled 29 patients (DED group, 11 eyes; non-DED group, 18 eyes) who underwent SMILE in our center from July to September 2022. The examinations on DED, refractive status and UDVA were performed before surgery, and on day 7 and 20 after surgery. The results showed that on day 20 after SMILE, subjects in the non-DED group reported greater changes of ocular surface disease index value increase and tear-film breakup time reduction compared to baseline than those in the DED group ( < 0.001 and = 0.048, respectively). Compared to preoperative status, DED patients had greater improvements of UDVA and better optometric outcomes on day 20 after surgery than non-DED subjects ( = 0.008 and 0.026, respectively). Multiple linear regression analysis showed age, contact lens daily wearing time, and tear meniscus height before surgery were of the highest value to predict UDVA on day 20 after SMILE in contact lens wearers ( = 0.006, 0.010 and 0.043, respectively). In conclusion, preoperative tear function could affect UDVA after SMILE. The impact of DED on UDVA and refraction should be taken into consideration before surgery.

Citing Articles

Short-Term Efficacy and Safety of Scleral Lenses in the Management of Severe Dry Eye in a Chinese Population.

Lu C, Han D, Zeng L, Hong J, Fadel D, Zhou X J Clin Med. 2025; 14(3).

PMID: 39941328 PMC: 11818766. DOI: 10.3390/jcm14030658.

References

Vehof J, Kozareva D, Hysi P, Hammond C . Prevalence and risk factors of dry eye disease in a British female cohort. Br J Ophthalmol. 2014; 98(12):1712-7. DOI: 10.1136/bjophthalmol-2014-305201. View

Dong Z, Zhou X, Wu J, Zhang Z, Li T, Zhou Z . Small incision lenticule extraction (SMILE) and femtosecond laser LASIK: comparison of corneal wound healing and inflammation. Br J Ophthalmol. 2013; 98(2):263-9. PMC: 3913294. DOI: 10.1136/bjophthalmol-2013-303415. View

Liu Y, Yam G, Lin M, Teo E, Koh S, Deng L . Comparison of tear proteomic and neuromediator profiles changes between small incision lenticule extraction (SMILE) and femtosecond laser-assisted in-situ keratomileusis (LASIK). J Adv Res. 2021; 29:67-81. PMC: 8020296. DOI: 10.1016/j.jare.2020.11.001. View

Goto E, Yagi Y, Matsumoto Y, Tsubota K . Impaired functional visual acuity of dry eye patients. Am J Ophthalmol. 2002; 133(2):181-6. DOI: 10.1016/s0002-9394(01)01365-4. View

Moshirfar M, McCaughey M, Reinstein D, Shah R, Santiago-Caban L, Fenzl C . Small-incision lenticule extraction. J Cataract Refract Surg. 2015; 41(3):652-65. DOI: 10.1016/j.jcrs.2015.02.006. View

Kim T, Alio Del Barrio J, Wilkins M, Cochener B, Ang M . Refractive surgery. Lancet. 2019; 393(10185):2085-2098. DOI: 10.1016/S0140-6736(18)33209-4. View

Kobashi H, Kamiya K, Shimizu K . Dry Eye After Small Incision Lenticule Extraction and Femtosecond Laser-Assisted LASIK: Meta-Analysis. Cornea. 2016; 36(1):85-91. DOI: 10.1097/ICO.0000000000000999. View

Chung B, Choi M, Lee K, Kim E, Seo K, Jun I . Comparing Dry Eye Disease After Small Incision Lenticule Extraction and Laser Subepithelial Keratomileusis. Cornea. 2019; 39(4):501-507. DOI: 10.1097/ICO.0000000000002240. View

Kobashi H, Kamiya K, Yanome K, Igarashi A, Shimizu K . Longitudinal assessment of optical quality and intraocular scattering using the double-pass instrument in normal eyes and eyes with short tear breakup time. PLoS One. 2013; 8(12):e82427. PMC: 3855746. DOI: 10.1371/journal.pone.0082427. View

10.

Xia F, Chen Z, Miao H, Wei R, Li M, Zhao J . Ten-year outcomes following small incision lenticule extraction for up to -10Dioptres myopia. Clin Exp Optom. 2023; 107(3):285-290. DOI: 10.1080/08164622.2023.2203313. View

11.

Toda I . Dry Eye After LASIK. Invest Ophthalmol Vis Sci. 2018; 59(14):DES109-DES115. DOI: 10.1167/iovs.17-23538. View

12.

Shah R, Shah S, Sengupta S . Results of small incision lenticule extraction: All-in-one femtosecond laser refractive surgery. J Cataract Refract Surg. 2010; 37(1):127-37. DOI: 10.1016/j.jcrs.2010.07.033. View

13.

Edorh N, El Maftouhi A, Djerada Z, Arndt C, Denoyer A . New model to better diagnose dry eye disease integrating OCT corneal epithelial mapping. Br J Ophthalmol. 2021; 106(11):1488-1495. DOI: 10.1136/bjophthalmol-2021-318826. View

14.

Ang M, Tan D, Mehta J . Small incision lenticule extraction (SMILE) versus laser in-situ keratomileusis (LASIK): study protocol for a randomized, non-inferiority trial. Trials. 2012; 13:75. PMC: 3404906. DOI: 10.1186/1745-6215-13-75. View

15.

Jin Y, Wang Y, Xu L, Zuo T, Li H, Dou R . Comparison of the Optical Quality between Small Incision Lenticule Extraction and Femtosecond Laser LASIK. J Ophthalmol. 2016; 2016:2507973. PMC: 5121460. DOI: 10.1155/2016/2507973. View

16.

Benitez-Del-Castillo J, Labetoulle M, Baudouin C, Rolando M, Akova Y, Aragona P . Visual acuity and quality of life in dry eye disease: Proceedings of the OCEAN group meeting. Ocul Surf. 2016; 15(2):169-178. DOI: 10.1016/j.jtos.2016.11.003. View

17.

Fu Y, Yin Y, Wu X, Li Y, Xiang A, Lu Y . Clinical outcomes after small-incision lenticule extraction versus femtosecond laser-assisted LASIK for high myopia: A meta-analysis. PLoS One. 2021; 16(2):e0242059. PMC: 7870077. DOI: 10.1371/journal.pone.0242059. View

18.

Eom Y, Lee J, Kang S, Kim H, Song J . Correlation between quantitative measurements of tear film lipid layer thickness and meibomian gland loss in patients with obstructive meibomian gland dysfunction and normal controls. Am J Ophthalmol. 2013; 155(6):1104-1110.e2. DOI: 10.1016/j.ajo.2013.01.008. View

19.

Le Q, Jiang C, Jiang A, Xu J . The analysis of tear meniscus in soft contact lens wearers by spectral optical coherence tomography. Cornea. 2009; 28(8):851-5. DOI: 10.1097/ICO.0b013e318197ec24. View

20.

Krueger R, Meister C . A review of small incision lenticule extraction complications. Curr Opin Ophthalmol. 2018; 29(4):292-298. DOI: 10.1097/ICU.0000000000000494. View