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Updated: May 9, 2025
Comparing Objective Conjunctival Hyperemia Grading and the Ocular Surface Disease Index Score in Dry Eye Syndrome During COVID-19
Published on: May 25, 2022
The effect of COVID-19 on visual outcome and dry eye after SMILE
Zhi Fang1, Yan Li1, Dejuan Song1
1Eye Center, The Second Affiliated Hospital of Zhejiang University School of Medicine; Zhejiang Provincial Key Laboratory of Ophthalmology; Zhejiang Provincial Clinical Research Center for Eye Diseases; Zhejiang Provincial Engineering Institute on Eye Diseases, Hangzhou, China.
Purposes:
To evaluate the impact of coronavirus disease 2019 (COVID-19) on postoperative visual acuity, optical quality, and severity of dry eye disease in patients after small incision lenticule extraction (SMILE).
Methods:
This is a retrospective, comparative study. Patients who underwent SMILE were included and divided into two groups according to the period at the eye center of the Second Affiliated Hospital of Zhejiang University. The first group included patients who underwent SMILE before the large-scale COVID-19 pandemic in China (Group 1). The second group comprised patients who underwent SMILE during the pandemic with a confirmed infection of COVID-19 (Group 2). The visual acuity, the severity of dry eye, ocular surface disease index (OSDI), oculus keratography analysis, and individual Zernike coefficients were evaluated and compared between the 2 groups.
Results:
A total of 43 eyes of 23 patients and 45 eyes of 26 patients were included in Groups 1 and 2, respectively. The OSDI score in Group 2 was significantly higher than Group 1 (P < 0.01). The corrected distance visual acuity (CDVA, logMAR) at 3 months postoperatively in Group 1 was better than in Group 2 (P < 0.001). Despite the improvement over 1 month after the COVID-19 infection, the OSDI score was still higher in Group 2 than in Group 1 (P < 0.01). The bulbar and limbal redness were significantly higher in Group 2 than in Group 1 at both 1 month and 3 months (P < 0.05), while no significant differences were found in tear breakup time or tear meniscus height. Spherical aberration (SA) at the 4 mm zone was significantly higher in Group 2 than in Group 1 both at 1 month and 3 months (P < 0.001), while no significant changes were observed in corneal total higher-order aberrations. No significant correlation was found between the bulbar/limbal redness index and SA.
Conclusions:
COVID-19 infection impaired visual outcomes and aggravated dry eye severity among postoperative SMILE patients.
