Analysis of dry eye syndrome incidence and prognostic factors in 778 patients following refractive corneal surgery
Year: 2026
Type: article
Study design: Observational Study
Abstract: OBJECTIVE: To investigate the incidence of dry eye syndrome following refractive corneal surgery and identify prognostic factors, thereby providing evidence-based guidance for precise clinical assessment and individualized management. METHODS: A retrospective cohort study was conducted including 778 patients (1598 eyes) aged 18-45 years who underwent refractive corneal surgery at our hospital between January and December 2020. Surgical procedures included LASIK, FS-LASIK, PRK, Smart transepithelial photorefractive keratectomy, and ICL implantation. Comprehensive preoperative ophthalmic examinations were performed, including assessment of dry eye-related parameters such as tear meniscus height and tear film break-up time (BUT). Subjective symptoms were evaluated using the Ocular Surface Disease Index (OSDI) questionnaire. Dry eye symptoms were assessed at 2 months postoperatively. Univariate analysis and multivariate logistic regression analysis were employed to identify independent risk factors for postoperative dry eye development. RESULTS: Among the 778 patients, 526 were male and 252 were female, with a mean age of 22.1 ± 5.2 years. The overall incidence of dry eye at 2 months postoperatively was 41.4% (662/1598 eyes). Ocular dryness was the most common symptom (78.5%), followed by foreign body sensation (65.3%) and photophobia (42.8%). Significant differences in dry eye incidence were observed among different surgical procedures (P = 0.012). Surface ablation procedures (PRK + Smart transepithelial PRK) demonstrated an incidence of 45.7%, significantly higher than lamellar procedures (LASIK + FS-LASIK) at 39.7% (P = 0.005). Univariate analysis revealed associations between postoperative dry eye and female gender, age 26-30 years, surface ablation procedures, preoperative tear meniscus height <0.2 mm, and preoperative BUT <10 s (P < 0.05). Multivariate logistic regression analysis identified independent risk factors: female gender (OR=1.24, 95%CI: 1.02-1.51, P = 0.032), surface ablation procedures (OR=1.32, 95%CI: 1.08-1.61, P = 0.007), preoperative tear meniscus height <0.2 mm (OR=1.58, 95%CI: 1.29-1.94, P < 0.001), and preoperative BUT <10 s (OR=1.45, 95%CI: 1.19-1.77, P < 0.001). CONCLUSION: Dry eye syndrome exhibits a relatively high incidence following refractive corneal surgery. Female gender, surface ablation procedures, and compromised preoperative tear film function constitute independent risk factors for postoperative dry eye development. Systematic preoperative assessment of tear film function is essential, with proactive intervention and individualized surgical planning recommended for high-risk patients to reduce postoperative dry eye incidence and enhance patient satisfaction.
Author: Min Zhang
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,610
OpenAlex ID: W7124274073