The impact of refractive technologies Femto Lasіk and ReLEx SMILE on the development of dry eye syndrome and the quality composition of tears in eyes with myopia and myopic astigmatism
DOI:
https://doi.org/10.14739/2310-1237.2024.3.307500Keywords:
myopia, myopic astigmatism, dry eye syndrome, quality composition of tears, refractive surgery, Femto Lasіk, ReLEx SMILEAbstract
Aim. To improve the quality of surgical treatment of myopia and myopic astigmatism by refining the indications for the selection of the correction method based on the study of tear crystallography.
Materials and methods. The article presents the results of the surgical treatment of 45 patients (90 eyes) with mild and moderate myopia and myopic astigmatism, who underwent vision correction using ReLEx SMILE and Femto Lasіk methods at the Visus Clinic of Modern Ophthalmology (Zaporizhzhia). Among the patients, there were 20 (45 %) men and 25 (55 %) women aged between 19 and 38 years (mean age 27.28 ± 1.08 years). They were divided into two groups. The first group consisted of 25 patients (50 eyes) who underwent vision correction using the ReLEx SMILE method. The second group included 15 patients (30 eyes) who underwent vision correction using the Femto Lasіk method. All patients underwent standard ophthalmological examinations, refractive diagnostics, and tear crystallography.
Results. In the postoperative period, the location and number of salt crystals in the central zone slightly changed. In the first group, multiple randomly located quadrangular crystals appeared in 6 eyes (12.0 %) compared to 2 eyes (4.0 %) before surgery. In the second group, these crystals were observed in 4 eyes (13.3 %), indicating minor changes in the salt component of the tear fluid, slightly more pronounced in the second group.
Conclusions. The study showed a minor impact of Femto Lasіk and ReLEx SMILE refractive surgeries on the protein-electrolyte state of the tear. Within a month after refractive surgery, the protein-salt composition of the tear, according to crystallography data, fully recovered in 96.0 % of cases where the ReLEx SMILE method was used and in 86.7 % of cases where the Femto Lasіk method was used (statistically significant difference p < 0.05). This allows for a preference for the ReLEx SMILE method when choosing a correction method for refractive anomalies, especially in eyes showing signs of dry eye syndrome.
References
Sharma B, Soni D, Saxena H, Stevenson LJ, Karkhur S, Takkar B, et al. Impact of corneal refractive surgery on the precorneal tear film. Indian J Ophthalmol. 2020;68(12):2804-12. doi: 10.4103/ijo.IJO_2296_19
Shen Z, Zhu Y, Song X, Yan J, Yao K. Dry Eye after Small Incision Lenticule Extraction (SMILE) versus Femtosecond Laser-Assisted in Situ Keratomileusis (FS-LASIK) for Myopia: A Meta-Analysis. PLoS One. 2016;11(12):e0168081. doi: 10.1371/journal.pone.0168081
Eydelman M, Hilmantel G, Tarver ME, Hofmeister EM, May J, Hammel K, et al. Symptoms and Satisfaction of Patients in the Patient-Reported Outcomes With Laser In Situ Keratomileusis (PROWL) Studies. JAMA Ophthalmol. 2017;135(1):13-22. doi: 10.1001/jamaophthalmol.2016.4587
Bower KS, Sia RK, Ryan DS, Mines MJ, Dartt DA. Chronic dry eye in photorefractive keratectomy and laser in situ keratomileusis: Manifestations, incidence, and predictive factors. J Cataract Refract Surg. 2015;41(12):2624-34. doi: 10.1016/j.jcrs.2015.06.037
Bilalov EN, Yusupov AF, Nozimov AE, Oripov OI. Estimation of lacrimal dysfunction indices in patients with recurrent pterygium. Ophthalmology Journal. 2020;13(1):11-6.
Bezkorovayna IM, Nakonechnyi DO, Bezkorovayna AO. [Characteristics of crystallographic changes in tear in different stages of diabetic retinopathy]. J Ophthalmol (Ukraine). 2018;(6):35-9. Ukrainian. doi: http://doi.org/10.31288/oftalmolzh201863539
Nair S, Kaur M, Sharma N, Titiyal JS. Refractive surgery and dry eye – An update. Indian J Ophthalmol. 2023;71(4):1105-14. doi: 10.4103/IJO.IJO_3406_22
Rolando M, Baldi F, Calabria G. Tear mucus crystallization in children with cystic fibrosis. Ophthalmologica. 1988;197(4):202-6. doi: 10.1159/000309944
The definition and classification of dry eye disease: report of the Definition and Classification Subcommittee of the International Dry Eye WorkShop (2007). Ocul Surf. 2007;5(2):75-92. doi: 10.1016/s1542-0124(12)70081-2
Zavhorodnia NH, Isakova OA. Rannia diahnostyka syndromu “sukhoho oka” shchodo otsinky yakisnoho skladu slozy [Early diagnosis of dry eye syndrome by assessing the qualitative composition of tears]. J Ophthalmol (Ukraine). 2005;(5):18-20. Ukrainian.
Drozhzhina GI, Gaidamaka TB, Troichenko LF. [Effect of tear substitutes with various sodium hyaluronate levels on the condition of eye anterior segment in dry eye syndrome patients]. J Ophthalmol (Ukraine). 2016;(6):6-11. doi: 10.31288/oftalmolzh20166611
Palme C, Mulrine F, McNeely RN, Steger B, Naroo SA, Moore JE. Assessment of the correlation of the tear breakup time with quality of vision and dry eye symptoms after SMILE surgery. Int Ophthalmol. 2022;42(3):1013-20. doi: 10.1007/s10792-021-02086-4
Downloads
Additional Files
Published
How to Cite
Issue
Section
License
Authors who publish with this journal agree to the following terms:- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (SeeThe Effect of Open Access).