The Effect Of Tear Production Impairment On The Severity Of Dry Eye Like Symptoms After Refractive Lenticule Extraction
Published 2026 - 44th Congress of the ESCRS
Reference: PP22.017 | Type: Free paper | DOI: 10.82333/aaaa-gs03
Authors: Prof. Dr Erika Eskina* 1 , Dr Viktoria Parshina 2 , Dr Teresa Tsai 3 , Dr Stephanie Joachim 3 , Prof. Dr Burkhard Dick 3
1Experimental Eye Research Institute, University Eye Hospital,Ruhr-University Bochum,Bochum,Germany;"Sphere" Eye Clinic,Moscow,Russian Federation, 2"Sphere" Eye Clinic,Moscow,Russian Federation, 3Experimental Eye Research Institute, University Eye Hospital,Ruhr-University Bochum,Bochum,Germany
Purpose
To compare the postoperative course of dry eye like symptoms after KLEx in patients with different preoperative ocular surface conditions and to evaluate whether mild pre-existing tear film alterations (dry eye) influence postoperative tear film stability and clinical outcomes.
Setting
Patients were operated at “Sphere” Eye Clinic, Moscow, Russia. The data was analyzed in Experimental Eye Research Institute, Ruhr-University Bochum, Germany
Methods
This retrospective study included 358 eyes (179 patients; 76 men, 103 women; mean age 28.9 ± 6.6 years) that underwent ReLex SMILE procedure. Patients were divided into two groups based on preoperative tear break-up time (TBUT): group 1 (174 eyes) with TBUT ≥13 seconds and group 2 (184 eyes) with TBUT <13 seconds. We compared uncorrected (UCVA) and corrected distance visual acuity (CDVA), refraction, pachymetry, Schirmer 2 test, tear meniscus height (TMH), and first as well as average TBUT preoperatively and at 1 day, 1 month, and 6 months postoperatively. All patients have had standard medication postoperatively.
Results
Preoperatively, groups differed significantly in regard to first and average TBUT. Group 1 had a mean first TBUT of 16.8 s and a mean average of 16,9 s, in group they were 2.7 s and 8.6 s (both p<0.01). At 1 month postop, the TMH differed significantly: It increased in group 1 up to 194 µm vs. 169 µm in group 2 (p<0.05). First and average TBUT decreased in group 1 up to 11.8 s and 13.01 s and increased in group 2 up to 9.5 s and 11.05 s respectively (both p<0.01). No significant differences between both groups were found in regard to VA, Schirmer test, or refractive target achievement. At 6 months postop the difference between groups kept stable without any statistically significant change of TBUT within the groups.
Conclusions
The results suggest divergent clinical patterns between classical dry eye disease and postoperative DED-like syndrome. While TBUT increased in the dry eye patients (group 2), it decreased in healthy patients (group 1), implying different underlying pathophysiological mechanisms. Further investigation is required.
Financial Disclosure. Stephanie Joachim is a consultant and speaker for Bausch + Lomb. The remaining authors declare no financial or proprietary interest in any material or method mentioned.