Preoperative and postoperative risk factors for persistent dry eye after corneal refractive surgery in ultra-high myopia: a retrospective cohort study.

Incidence, severity, and predictors of early postoperative dry eye disease following femtosecond laser-assisted in situ keratomileusis (FS-LASIK): a short-term, single-center retrospective analysis

Predictive factors associated with the safety and efficacy of refractive surgery for Myopia: a retrospective cohort study.

Post-vitrectomy dry eye: a prospective study of ocular surface changes and associated risk factors.

PURPOSE To evaluate the effect of pars plana vitrectomy (PPV) on dry eye signs and symptoms and identify associated factors. METHODS This prospective study included 60 consecutive patients undergoing primary PPV. Dry eye was assessed preoperatively and at one and three months postoperatively using Schirmer test, tear break-up time (TBUT), corneal and conjunctival staining, tear osmolarity, and the Ocular Surface Disease Index (OSDI) questionnaire. RESULTS Sixty patients (mean age 70.4 years; 67% female) were enrolled. Combined phaco-vitrectomy was performed in 43.7% of cases, and 78.3% received retrobulbar anesthesia. Mean Schirmer scores declined at one month compared with baseline (8.5 mm vs. 11.7 mm, p = 0.014) and returned toward baseline by three months. Inferior conjunctival lissamine green staining and lubricant use increased at one month (p = 0.039 and p = 0.014). OSDI scores remained unchanged at one month compared to baseline (p = 0.756) but improved at three months compared with baseline (25.4 vs. 32.5, p = 0.042). TBUT, superficial punctate keratopathy, and osmolarity did not demonstrate statistically significant changes. Older age correlated with lower Schirmer values at one month (r = - 0.427, p = 0.006). In multivariate analysis, operative duration was independently associated with greater SPK scores and lower TBUT values. CONCLUSIONS PPV is associated with transient ocular surface alterations, most evident at one month postoperatively, with partial recovery by three months. Older age and longer operative duration are independently associated with greater susceptibility to postoperative dry eye. OSDI scores should be interpreted cautiously after retinal surgery, as visual recovery may influence reported symptoms.

Ocular Symptoms After Refractive Surgery.

Importance Characterizing individual ocular symptom trajectories following laser-assisted in situ keratomileusis (LASIK) and photorefractive keratectomy (PRK) may provide a longitudinal, patient-centered perspective on postoperative recovery and help identify patients at risk of prolonged symptom courses. Objective To characterize longitudinal ocular symptom trajectories after refractive surgery, describe associated symptom descriptors over time, and identify baseline factors associated with pain trajectories. Design, Setting, and Participants This prospective, multicenter cohort study was conducted at 2 academic ophthalmology centers in the US from April 2021 to July 2025. Adults undergoing bilateral LASIK or PRK were enrolled and evaluated preoperatively and at postoperative day 1 (POD 1) and months 3 (POM 3) and 6 (POM 6). Participants eligible for refractive surgery were included. Exclusion criteria included pregnancy, corneal abnormality (scar, ectasia, corneal surgery), eye diseases that could confound ocular pain (glaucoma, herpetic eye disease), and age younger than 18 years. Main Outcomes and Measures Ocular pain intensity measured using numerical rating scale (NRS; 0-10) at baseline, POD 1, POM 3, and POM 6. Clinically relevant pain was defined as an NRS score of 3 or greater. Trajectories were classified based on clinically relevant pain presence across time points; baseline demographic, clinical, surgical, and ocular surface factors were evaluated as associated factors. Results Among 326 participants with complete pain data (mean [SD] age, 34.3 [7.9] years; 196 [60.1%] female), pain trajectories were heterogeneous. No clinically relevant pain was observed in 94 participants (28.8%), pain at POD 1 only in 143 participants (43.9%), and prolonged pain (at POM 3 or POM 6) in 59 participants (18.1%); 30 participants had uncommon pain trajectories. Prolonged pain was independently associated with PRK (vs LASIK: odds ratio [OR], 2.73; 95% CI, 1.29-5.77) and several preoperative factors, including lubricating drop use (OR, 2.41; 95% CI, 1.17-4.96), chronic low back pain (OR, 2.45; 95% CI, 1.14-5.25), and greater ocular symptom burden (5-Item Dry Eye Questionnaire score: OR, 1.11; 95% CI, 1.01-1.22). The presence of corneal staining at 6 months after surgery was associated with lower odds of prolonged pain (OR, 0.79; 95% CI, 0.64-0.97). Conclusions and Relevance In this cohort study, postoperative ocular symptom trajectories after refractive surgery followed distinct longitudinal patterns, suggesting these trajectories may have been associated with specific baseline factors. This trajectory-based, symptom-specific approach may provide clinically relevant insight into patient recovery and may improve risk stratification, counseling, and targeted perioperative management, but further corroboration is warranted.

Clinical Profile, Risk factors and Topographic Characteristics of Keratoconus at a Tertiary Eye Hospital: An Observational Study

Introduction: Keratoconus is a non-inflammatory, progressive thinning, most commonly bilateral condition of the cornea involving the central two-thirds of the cornea. The study aimed to assess the clinical profile, risk factors, and topographic parameters. Methods: An observational study was conducted from March to November 2024 among patients with clinically and topographically diagnosed keratoconus. Corneal topography-800 and the Amsler–Krumeich classification were used for diagnosis and grading. Binary variables were summarized as frequencies and percentages, while continuous variables were expressed as mean, standard deviation, and coefficient of variation. Results: Among the 82 keratoconus patients 120 eyes were evaluated, the mean age of presentation was 22.37±8.7 years. The study population included 64 (78.05%) males and 18 females (21.95%). Reported risk factor were eye rubbing 52 (37.96%), ocular allergy 44 (32.12%). Unilateral keratoconus was seen in 46 (56.10%) cases. The observed clinical sign was scissor reflex 62 (75.61%), stromal thinning 50 (60.98%) and Vogt's striae 36 (43.90%). Refractive parameters showed considerable variation, with spherical power averaging -1.16±2.05 D and cylindrical power at -4.16±2.88 D, confirming significant myopia and astigmatism. Corneal curvature was increased, with a mean K value of 47.30±5.50 D, and the surface asymmetry index was 2.44±2.19, indicating variations in corneal topography. Conclusions: In this study, majority of the patients were in early twenty's age group. The most early sign for the detection of keratoconus was scissor reflex and as the severity of keratoconus increased the central corneal thickness and best corrected visual acuity decreased.

Clinical profile and perioperative risk factors for post-cataract surgery nonarteritic anterior ischemic optic neuropathy in an Indian population: An emulated target trial

Purpose: Cataract surgery is associated with a four times increased risk of nonarteritic anterior ischemic optic neuropathy (NAION). This paper presents the first report of patients from Indian ethnicity with post-cataract surgery NAION (psNAION) and aims to evaluate perioperative risk factors for prediction of psNAION. Methods: A retrospective evaluation of patients who developed psNAION was done and clinical characteristics noted. An emulated target trial to evaluate the role of perioperative blood pressure and blood sugar, and postoperative intraocular pressure was conducted with controls matched for age, sex, systemic and ocular comorbidities with known risk of NAION, grade of cataract, type of surgery, type of anesthesia, and intraoperative complications. Results: Nineteen patients (8 males, 11 females) aged 66.6 ± 7.7 years developed psNAION 80.8 ± 50.6 days after cataract surgery. Five (21.1%) patients had no known systemic risk factors for NAION. Three patients presented <7 days and 16 presented >6 weeks from surgery. None of the evaluated variables (perioperative blood pressure and blood sugar, and postoperative intraocular pressure) correlated significantly with increased risk of psNAION. Conclusion: Onset of psNAION is much later in Indian patients. All patients had classical features of NAION, and clinical evaluation was sufficient to establish diagnosis. One-fifth of patients had no known coexisting risk factors. Perioperative control of blood pressure or blood sugar, and postoperative intraocular pressure were not associated with increased risk.