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

Authors

DOI:

https://doi.org/10.14739/2310-1237.2024.3.307500

Keywords:

myopia, myopic astigmatism, dry eye syndrome, quality composition of tears, refractive surgery, Femto Lasіk, ReLEx SMILE

Abstract

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.

Author Biographies

N. H. Zavhorodnia, Zaporizhzhia State Medical and Pharmaceutical University, Ukraine

MD, PhD, Professor, Head of the Department of Ophthalmology

Yu. Yu. Doroshenko, Zaporizhzhia State Medical and Pharmaceutical University, Ukraine

MD, Visus LTD, Zaporizhzhia; PhD-student of the Department of Ophthalmology

I. O. Poplavska, Zaporizhzhia State Medical and Pharmaceutical University, Ukraine

MD, PhD, Associate Professor of the Department of Ophthalmology

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

Additional Files

Published

2024-12-27

How to Cite

1.
Zavhorodnia NH, Doroshenko YY, Poplavska IO. 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. Pathologia [Internet]. 2024Dec.27 [cited 2025Jan.15];21(3):232-7. Available from: http://pat.zsmu.edu.ua/article/view/307500

Issue

Section

Original research