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Ocular surface diseases and corneal refractive surgery.

Debora Garcia-Zalisnak1, David Nash, Elizabeth Yeu

  • 1Eastern Virginia Medical School, Virginia Eye Consultants, Norfolk, Virginia, USA.

Current Opinion in Ophthalmology
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Understanding dry eye disease mechanisms and patient risk factors can improve outcomes for corneal refractive surgery. Novel therapies and surgical techniques like SMILE and LASIK can enhance patient satisfaction and expand candidacy for refractive procedures.

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Area of Science:

  • Ophthalmology
  • Corneal Surgery
  • Ocular Surface Disease

Background:

  • Ocular surface disease is a significant concern in patients undergoing corneal refractive surgery.
  • Dry eye disease (DED) can be exacerbated or induced by keratorefractive procedures.

Purpose of the Study:

  • To review and update recent literature on ocular surface disease in the context of corneal refractive surgery.
  • To explore the mechanisms, prevention, and management of DED following refractive surgery.

Main Methods:

  • A literature search was conducted on the Medline database.
  • Studies focusing on DED mechanisms, surgical techniques, and therapeutic interventions were included.

Main Results:

  • Refractive surgery can induce or worsen dry eye disease.
  • Surgical techniques like small-incision lenticule extraction (SMILE) and femtosecond laser-assisted in-situ keratomileusis (LASIK) may be beneficial for at-risk patients.
  • Established therapies (artificial tears, cyclosporins, punctal plugs, autologous serum) and novel treatments (IGF-1, neuropeptides, acupuncture) show promise.

Conclusions:

  • Understanding DED mechanisms and patient risk factors is crucial for optimizing surgical outcomes and patient satisfaction.
  • Early intervention with appropriate therapies and surgical modifications can improve outcomes and potentially increase candidacy for refractive surgery.