Can Pre Operative Epithelial Maps & Tear Biomarkers Predict Post Operative Outcomes & Satisfaction?
Published 2026 - 44th Congress of the ESCRS
Reference: FP29.12 | Type: Free paper | DOI: 10.82333/5pjb-k687
Authors: Dr Sunayana Narasimha Murthy* 1 , A/Prof. ROHIT SHETTY 1 , Dr Swaminathan Sethu 2 , Dr ARKASUBRA GOSH 3
1REFRACTIVE SURGERY,NARAYANA NETHRALAYA,BANGALORE,India, 2GROW LAB,NARAYANA NETHRALAYA,BANGALORE,India, 3IMAGING, BIOMECHANICS AND MATHEMATICAL MODELLING SOLUTIONS LAB,NARAYANA NETHRALAYA,BANGALORE,India
Purpose
To evaluate how preoperative corneal epithelial mapping impacts postoperative visual quality and patient-reported quality of life (QoL) in cataract surgery patients, using Artificial Intelligence (AI) to identify predictive markers.
Setting
hopsital based sampling done at the cataract refractive department. prospective cross sectional study between May 2025 - September 2025
Methods
Two hundred fifty patients underwent pre- and postoperative evaluation, including epithelial mapping (Placido–OCT and ray-tracing–based system) and tear biomarker analysis using the BioM Pathfinder kit. Based on epithelial status, Group 1 (n=169) had regular epithelium and Group 2 (n=81) had irregular epithelium. Postoperative assessments included UCVA, PROWL scores, OQAS, and epithelial/corneal HOAs. AI algorithms were applied to identify predictors of visual and QoL outcomes.
Results
UCVA gains were comparable across groups. However, Group 1 had significantly better visual quality and QoL scores (PROWL>80 in 162/169 patients), while Group 2 had poorer outcomes (PROWL<80 in 48/81). Corneal HOAs and inflammatory biomarkers were markedly elevated in Group 2 (p<0.05). AI identified epithelial irregularity as a key predictor of both reduced visual quality and lower QoL.
Conclusions
Corneal epithelial mapping and tear biomarkers serve as effective surrogate markers for predicting both visual outcomes and postoperative quality of life following cataract surgery