Retrospective Analysis Of The Impact Of Dry Eye Disease And Its Treatment On The Tomographic Biomechanical Index Optimized For East Asian Populations (Ctbi) In Filipino Laser Vision Correction Candidates

To evaluate the association between dry eye disease (DED) and the corneal tomographic biomechanical index optimized for East Asian Populations (cTBI) in Filipino adults undergoing laser vision correction screening and to determine whether DED or its treatment alters corneal tomographic biomechanical measurements that may confound ectasia risk stratification.

Laser Refractive Center, The Medical City, Philippines

Retrospective observational study of 298 eyes (149 adults) screened for laser vision correction. Clinicodemographic data, tear breakup time (TBUT), tear breakup pattern, corneal staining, and cTBI measurements from the Pentacam® AXL Wave (Oculus Optikgeräte GmbH; Wetzlar, Germany) and OCULUS Corvis® ST (Wetzlar, Germany) were collected before and after DED treatment. Eyes were stratified by DED status. Each eye was analyzed separately.

DED prevalence was 84.6% (n=126 patients). Patients with DED showed worse tear film stability and staining but similar refractive profiles. Baseline and post-treatment cTBI values did not differ between DED and non-DED groups (p>0.05). Post-treatment of DED, 98.64% (n=217 eyes) remained normal, 14.29% (n=2 eyes) improved from suspicious to normal, and 40% (n=2 eyes) improved from abnormal to normal. Nonetheless, within-group changes were minimal and nonsignificant. Absolute, relative, and difference-in-differences analyses showed no effect of DED on cTBI. Subgroup analyses by TBUT, tear breakup pattern, and corneal staining demonstrated consistent stability of tomographic biomechanical measures, with minimal risk category transitions.

Despite a high prevalence of ocular surface disease, DED and short-term treatment did not meaningfully influence cTBI. Corneal tomographic biomechanical assessment remained stable across groups, supporting the reliability of cTBI for laser vision correction screening even in patients with tear film instability. While this study shows that DED is unlikely to be a major confounder in tomographic biomechanical risk evaluation, larger prospective investigations are recommended for risk category transitions among eyes with DED.