Journal of refractive surgery最新文献

{"title":"Corneal Wavefront-Guided Transepithelial PRK Aligned to Comatic Axis After Corneal Cross-linking for Keratoconus.","authors":"Luis Izquierdo, Isabel Gómez, Claudia Pomatanta, Clara Bonel, Ana Paola Mercado, Samuel Arba-Mosquera, Rolando Rojas, Guillermo Raul Vera-Duarte, Maria A Henriquez","doi":"10.3928/1081597X-20260601-01","DOIUrl":"https://doi.org/10.3928/1081597X-20260601-01","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the clinical outcomes of a comatic axis-adjusted corneal wavefront-guided transepithelial photorefractive keratectomy (TransPRK) protocol for visual rehabilitation in patients with keratoconus previously treated with corneal cross-linking (CXL).</p><p><strong>Methods: </strong>In this prospective, non-randomized, consecutive case series, 24 eyes from 17 patients with stable stage I to III keratoconus after CXL underwent anterior wavefront-guided TransPRK centered on the comatic axis, using large optical zones and a tissue-saving ablation algorithm (⩽90 µm total, ⩽50 µm stromal). Main outcome measures included changes in corrected (CDVA) and uncorrected distance visual acuity, corneal higher order aberrations (HOAs), keratometric indices, and pachymetric parameters. Follow-up evaluations were performed at 1, 3, and 6 months.</p><p><strong>Results: </strong>At 6 months, mean uncorrected distance visual acuity improved significantly from 0.83 ± 0.55 to 0.39 ± 0.20 logarithm of the minimum angle of resolution (logMAR) (<i>P</i> = .003), whereas CDVA improved from 0.21 ± 0.17 to 0.10 ± 0.08 logMAR (<i>P</i> = .002). Corneal HOAs decreased from 2.69 ± 1.18 to 1.95 ± 1.07 µm (<i>P</i> = .0002), with vertical coma showing the most significant reduction (<i>P</i> < .0001). Maximum keratometry values decreased from 54.32 ± 5.79 to 51.52 ± 4.93 diopters (<i>P</i> = .001). No eyes lost lines of CDVA or developed ectasia progression or clinically significant haze during follow-up.</p><p><strong>Conclusions: </strong>Comatic axis-aligned anterior corneal wavefront-guided TransPRK in stable post-CXL keratoconus showed favorable short-term visual, aberrometric, and topographic outcomes while preserving corneal integrity, and may represent a feasible tissue-sparing strategy for optical regularization in irregular corneas.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"42 10","pages":"e395-e403"},"PeriodicalIF":2.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum for \"Rotationally Asymmetric Refractive Low Addition Multifocal IOL Implantation in Patients with Previous Hyperopic Corneal Laser Refractive Surgery\".","authors":"","doi":"10.3928/1081597X-20260903-02","DOIUrl":"https://doi.org/10.3928/1081597X-20260903-02","url":null,"abstract":"","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"42 10","pages":"e512"},"PeriodicalIF":2.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corneal Biomechanical Metrics by Corvis ST in a Mexican Population: Normative Data and Population-Specific Implications for Intraocular Pressure Assessment.","authors":"Daniela Fabregas-Sanchez-Woodworth, Simran Mangwani-Mordani, José Y Arteaga-Rivera, Oscar G Lopez-Lechuga, Jorge E Valdez-García, Luis Haro-Morlett, Alejandro Navas, Enrique O Graue-Hernandez, Arturo Ramirez-Miranda","doi":"10.3928/1081597X-20260807-02","DOIUrl":"https://doi.org/10.3928/1081597X-20260807-02","url":null,"abstract":"<p><strong>Purpose: </strong>To establish normative corneal biomechanical parameters measured with the Corvis ST (Oculus Optikgeräte GmbH) in a healthy Mexican population and to evaluate the influence of intraocular pressure (IOP) and central corneal thickness (CCT) on dynamic corneal response metrics relevant to refractive surgery screening.</p><p><strong>Methods: </strong>In this cross-sectional study, healthy adults undergoing refractive surgery were assessed using the Corvis ST. When image quality criteria were met, both eyes were included. Dynamic corneal response parameters, IOP, and CCT were recorded. Reference intervals were calculated using the Hoffmann method. Associations between CCT, IOP, and biomechanical parameters were analyzed using Pearson correlation coefficients. Comparative analyses with previously published normative datasets from other populations were performed. A multivariable linear regression model was developed to explore a population-specific approach to biomechanically corrected IOP (bIOP).</p><p><strong>Results: </strong>A total of 511 eyes were analyzed. Several Corvis ST-derived biomechanical parameters showed statistically significant differences when compared with previously reported data from other ethnic populations. CCT demonstrated weak but significant correlations with multiple biomechanical metrics, whereas IOP showed stronger associations, particularly with deformation amplitude, peak distance, and second applanation time (all <i>P</i> < .001). No clinically meaningful correlation was observed between IOP and the Corvis Biomechanical Index. A regression-based population-specific bIOP estimate differed significantly from the standard Corvis ST-derived bIOP (<i>P</i> < .0001) while maintaining a strong positive correlation.</p><p><strong>Conclusions: </strong>Corneal biomechanical behavior measured with the Corvis ST demonstrates population-specific characteristics in healthy Mexican eyes. IOP exerts a substantial influence on several dynamic corneal response parameters, underscoring the importance of pressure-aware interpretation in refractive surgery screening. Population-specific calibration of biomechanical metrics, including bIOP estimation, may enhance the accuracy of biomechanical assessment for ectasia risk stratification and preoperative refractive evaluation.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"42 10","pages":"e477-e484"},"PeriodicalIF":2.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sutureless Epikeratophakia After Small Incision Lenticule Extraction: A Case Report to Correct Corneal Deformity.","authors":"Ivey Thornton, Jiawei Wu, Ronald R Krueger, Lu Xiong, Qian Chen, Zheng Wang","doi":"10.3928/1081597X-20260714-02","DOIUrl":"https://doi.org/10.3928/1081597X-20260714-02","url":null,"abstract":"<p><strong>Purpose: </strong>To describe a novel therapeutic approach using transepithelial phototherapeutic keratectomy (t-PTK) combined with sutureless epikeratophakia to manage a severe corneal deformity and irregular hyperopic astigmatism caused by a femtosecond laser malfunction during keratorefractive lenticule extraction (KLEx).</p><p><strong>Methods: </strong>An 18-year-old woman presented with severe corneal thinning (residual stromal bed of 176 μm) and irregular astigmatism in the left eye following complicated KLEx. Management involved customized t-PTK (80 μm depth, 7.2 mm diameter) to prepare a regular stromal bed, followed by sutureless overlay of an allogeneic donor lenticule harvested from a KLEx. Topography-guided transepithelial photorefractive keratectomy (t-PRK) was performed 5 months postoperatively to refine the residual corneal irregularity and refractive outcome.</p><p><strong>Results: </strong>The graft integrated successfully without sutures. Topography confirmed significant regularization of the corneal surface, and the patient achieved an uncorrected distance visual acuity of 20/16 at the final follow-up.</p><p><strong>Conclusions: </strong>Sutureless epikeratophakia combined with customized surface ablation provides a safe, effective alternative for reconstructing irregular, severely thinned corneas following surgical complications.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"42 10","pages":"e497-e505"},"PeriodicalIF":2.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Visual Performance of a Novel Intraocular Lens With Higher-Order Aspheric Design Optimized for Intermediate Vision.","authors":"Nuria Garzón, Pedro Arriola-Villalobos, Natalia Hormigo-Márquez, María García-Montero, César Albarrán-Diego","doi":"10.3928/1081597X-20260806-02","DOIUrl":"https://doi.org/10.3928/1081597X-20260806-02","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the visual performance of an enhanced monofocal intraocular lens (IOL) and the influence of pupil size.</p><p><strong>Methods: </strong>This prospective, observational, single-center study was conducted at Hospital Clínico San Carlos (Madrid, Spain). Patients undergoing cataract surgery with an enhanced monofocal IOL (enVista Aspire; Bausch + Lomb, Inc) were included. Postoperative monocular assessments were performed under photopic conditions at 3 months. Uncorrected and corrected visual acuity were measured at distance (4 m), intermediate (66 cm), and near (40 cm). Defocus curves and photopic contrast sensitivity were assessed, and automated refraction was compared with manifest refraction. Defocus curves were analyzed using area-under-the-curve and depth-of-focus metrics, and visual outcomes were stratified by photopic pupil size (<3.5 vs ⩾3.5 mm). Agreement between autorefractometry and subjective refraction was evaluated using Bland-Altman analysis.</p><p><strong>Results: </strong>Twenty-two eyes of 22 patients were included. Mean postoperative uncorrected and corrected distance visual acuity was 0.09 ± 0.12 and -0.02 ± 0.07 logarithm of the minimum angle of resolution (logMAR), respectively; 19 eyes (86.4%) achieved uncorrected distance visual acuity of 0.2 logMAR or better and all eyes achieved corrected distance visual acuity of 0.1 logMAR or better. Mean corrected intermediate and near visual acuity were 0.32 ± 0.13 and 0.52 ± 0.18 logMAR, respectively. Contrast sensitivity showed a normal band-pass profile. Agreement between autorefractometry and manifest refraction showed a small mean bias for spherical equivalent (+0.08 diopters). Pupil size showed no overall main effect on defocus curves or contrast sensitivity, although a defocus-specific interaction was observed.</p><p><strong>Conclusions: </strong>This enhanced monofocal IOL provided excellent distance visual acuity, functional intermediate vision, preserved contrast sensitivity, and limited overall dependence on pupil size.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"42 10","pages":"e468-e476"},"PeriodicalIF":2.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Large Language Models for Selecting Intraocular Lens Power Calculation Formulas: A Comparative Study.","authors":"Hao Chen, Mingyu Qin, Ruiling Zhu, Xueyan Zhang, Wei Lou","doi":"10.3928/1081597X-20260806-01","DOIUrl":"https://doi.org/10.3928/1081597X-20260806-01","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate refractive outcomes of large language model (LLM)-based selection of the optimal intraocular lens power calculator according to individual biometric parameters.</p><p><strong>Methods: </strong>Two hundred eight eyes undergoing routine cataract surgery were included. Ten leading LLMs (Gemini, Chat-GPT, Perplexity, Grok, DeepSeek, Kimi, Qwen, Doubao, ERNIE, and Hunyuan) were prompted to recommend \"the single most appropriate formula\" from Barrett Universal II (BUII), Cooke K6, EVO 2.0, Hill-RBF 3.0, Kane, and PEARL-DGS, based on axial length (AL), keratometry, anterior chamber depth, and lens thickness. Gemini was excluded because it consistently selected Kane. Precision (SD) and accuracy (absolute spherical equivalent prediction error [SEQ-PE]) were assessed with the Eyetemis Analysis Tool and compared with BUII and SRK/T, both overall and within AL subgroups.</p><p><strong>Results: </strong>Formula preferences varied markedly among LLMs. Overall, all LLMs and BUII demonstrated significantly greater precision than SRK/T, with Hunyuan, ChatGPT, and BUII showing highest precision and significantly improved accuracy compared to SRK/T (all <i>P</i> < .05). The leading percentages of eyes within the ±0.50 diopter (D) threshold were achieved by Perplexity (82.69%), ChatGPT (82.21%), Qwen (82.21%), and BUII (81.73%). Across AL subgroups, at least one LLM numerically outperformed BUII in both precision and accuracy; at the ±0.50 D threshold, certain models increased this percentage over BUII by approximately 3% when AL was ≤ 22 mm or ≥ 26 mm, and by 8% when 24.5 mm ≤ AL < 26 mm.</p><p><strong>Conclusions: </strong>Compared with BUII, current LLMs exhibit limited capacity to improve refractive outcomes by selecting the optimal formulas for routine practice; however, certain LLMs show promise as adjunctive tools for personalized selection tailored to specific ALs.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"42 10","pages":"e458-e467"},"PeriodicalIF":2.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation Between Lens Density and Inter-Method Difference in Axial Length: Sum-of-Segments Versus Traditional Method on a Novel SS-OCT Biometer and the IOLMaster 700.","authors":"Mingzhen Yang, Yujuan Zhang, Danye Mei, Yi Shi, Xin Zhong, Andrzej Grzybowski, Geng Wang","doi":"10.3928/1081597X-20260803-01","DOIUrl":"https://doi.org/10.3928/1081597X-20260803-01","url":null,"abstract":"<p><strong>Purpose: </strong>To compare axial length (AL) measurements from a novel swept-source optical coherence tomography (SSOCT) biometer ZW-30 (sum-of-segments [SOS], traditional modes) (TowardPi Medical Technology Ltd) with the IOLMaster700 (Carl Zeiss Meditec AG), and evaluate the correlation between lens nuclear density and inter-device AL differences, as well as their impact on intraocular lens formula accuracy.</p><p><strong>Methods: </strong>Patients undergoing cataract surgery with preoperative biometry performed by the ZW-30 and IOLMaster700 were included. Lens density was quantified with SS-OCT scans using ImageJ software (National Institutes of Health). Correlations between lens density and AL differences were analyzed. Refractive prediction accuracy of the Barrett Universal II (BUII), Emmetropia Verifying Optical (EVO), and the Prediction Enhanced by Artificial Intelligence and output Linearization-Debellemanière, Gatinel, and Saad (PEARL-DGS) formulas were evaluated 1 month postoperatively. Eyes were stratified into short (< 22.00 mm), medium (22.00 mm ≤ AL < 24.50 mm), and long (≥ 24.50 mm) AL groups.</p><p><strong>Results: </strong>In the entire cohort (n = 74), no significant AL difference was found among the three methods (<i>P</i> = .578). However, subgroup analysis revealed significant differences in medium and long eyes (both <i>P</i> < .01). Lens nuclear density correlated positively with AL in the entire cohort (<i>r</i> = 0.39 to 0.40, <i>P</i> < .001) and long AL group (<i>r</i> = 0.52 to 0.55, <i>P</i> < .05), and with AL discrepancy between ZW-30 SOS and IOLMaster 700 in long AL eyes (<i>r</i> = 0.49, <i>P</i> < .05). No correlation was found between lens density and formula prediction error (<i>P</i> > .05). The EVO and BUII formulas demonstrated significantly lower mean absolute error than the PEARL-DGS formula across all measurement modes (all <i>P</i> < .001).</p><p><strong>Conclusions: </strong>Agreement between the ZW-30 and IOLMaster700 appeared to decrease in medium and long eyes, with discrepancy correlating with lens density in long eyes, although this finding requires confirmation in larger samples. The EVO and BUII formulas provided favorable refractive predictions compared with the PEARL-DGS.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"42 10","pages":"e431-e440"},"PeriodicalIF":2.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of Keratorefractive Lenticule Extraction in Older Adults: A Multicenter Analysis.","authors":"Lukas Neuhann, Amir Javadi, Stefan Kassumeh, Paul Emesz, Niklas Mohr, Anke Messerschmidt-Roth, Walter Sekundo, Martin Bechmann, Rainer Wiltfang, Martin Dirisamer, Siegfried G Priglinger, Nikolaus Luft","doi":"10.3928/1081597X-20260705-01","DOIUrl":"10.3928/1081597X-20260705-01","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the safety, efficacy, and refractive outcomes of keratorefractive lenticule extraction (KLEx) in adults aged 55 years or older compared to patients 35 years or younger, addressing the limited evidence for KLEx in presbyopic eyes.</p><p><strong>Methods: </strong>This retrospective multicenter study included patients aged 55 years or older and a control group aged 35 years or younger matched by preoperative mean refractive spherical equivalent (MRSE), all undergoing KLEx for myopia or myopic astigmatism. Preoperative parameters and postoperative refractive and visual outcomes were analyzed.</p><p><strong>Results: </strong>A total of 288 eyes of 183 patients were analyzed (144 were 55 years or older, 144 were 35 years or younger), with comparable baseline parameters between groups. Postoperative UDVA was slightly inferior in older adults (mean: -0.01 vs -0.07 logarithm of the minimum angle of resolution; 20/20 or better in 79% vs 93%, <i>P</i> < .001). The efficacy index was 0.94 versus 1.07 and the safety index was 1.01 versus 1.09 (both <i>P</i> < .001) for patients 55 years or older and 35 years or younger, respectively. Eleven percent of older patients and 39% of younger patients gained lines. A postoperative MRSE within ±0.50 diopters (D) was achieved by 76% of older versus 88% of younger patients (<i>P</i> = .02) and more than 95% were within ±1.00 D in both groups. Re-treatments were more frequent in older eyes (9% vs 1%, <i>P</i> = .01). Stability and astigmatic outcomes were comparable, although older eyes showed mild cylindrical overcorrection.</p><p><strong>Conclusions: </strong>KLEx in patients aged 55 years or older provided favorable and stable outcomes but was inferior when compared to younger cohorts regarding efficacy, safety, and predictability. These findings point to clinically meaningful age-related corneal biomechanical changes and carry implications for both surgical planning and patient counseling.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"42 9","pages":"e933-e941"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148920434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term Efficacy and Safety of the Implantable Collamer Lens in Eyes With an Anterior Chamber Depth of 2.6 to 2.8 mm.","authors":"Hongyu Kong, Lingling Niu, Junfeng Li, Li Wang, Xiaoying Wang, Xingtao Zhou, Yishan Qian","doi":"10.3928/1081597X-20260707-02","DOIUrl":"https://doi.org/10.3928/1081597X-20260707-02","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the long-term visual outcomes of the Implantable Collamer Lens (ICL) with a central hole (ICL V4c; STAAR Surgical) in eyes with an anterior chamber depth (ACD) of 2.6 to 2.8 mm.</p><p><strong>Methods: </strong>This retrospective, non-comparative, interventional case series included 41 eyes of 41 patients receiving ICL V4c implantation for myopia or myopic astigmatism that were observed for 7.76 ± 0.92 years (range: 6 to 10 years). Analyzed parameters included corrected distance visual acuity (CDVA) and uncorrected distance visual acuity, manifest refraction, endothelial cell density (ECD), intraocular pressure (IOP), lens parameters, angle opening distance at 500 μm (AOD500), trabecular-iris angle (TIA), iris curvature, and haptic position.</p><p><strong>Results: </strong>At the final follow-up visit, the mean vault was 234.66 ± 131.63 μm (range: 26 to 574 μm) and 35 eyes (85.4%) had two or more haptics not located in the ciliary sulcus. The safety index was 1.20 ± 0.31 (range: 1.00 to 2.80); no eyes lost CDVA. The efficacy index was 0.85 ± 0.27 (range: 0.24 to 1.40). No pupillary block or IOP elevation requiring medication was observed. Peripheral anterior subcapsular cataract developed in three eyes (7.31%). ECD decreased by 9.39% (annual loss 30.24 ± 51.35 cells/mm²). AOD500 and TIA decreased by 24.11% and 27.43%, respectively, with no angle closure observed on ultrasound biomicroscopy.</p><p><strong>Conclusions: </strong>ICL implantation in eyes with an ACD of 2.6 to 2.8 mm demonstrated acceptable long-term viability, provided that rigorous endothelial monitoring is maintained.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"42 9","pages":"e895-e905"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148920266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Dry Eye Treatment on Biomechanics in Refractive Surgery Candidates.","authors":"Zhen Ling Teo, Cheng Yi Loo, Gayathri Govindasamy, Ashraf M Mahmoud, Cynthia J Roberts, Jodhbir S Mehta","doi":"10.3928/1081597X-20260629-03","DOIUrl":"https://doi.org/10.3928/1081597X-20260629-03","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate changes in corneal biomechanical parameters after dry eye treatment for refractive surgery candidates.</p><p><strong>Methods: </strong>In this retrospective, cohort, single-center study, adults older than 21 years who presented for refractive surgery assessment from August 2020 to July 2022 were included. Patients underwent history taking, ocular examination, corneal tomography, and biomechanical evaluation. Patients with abnormal Tomographic Biomechanical Index (TBI) values or clinical signs of dry eye disease underwent dry eye treatment and repeat biomechanical evaluation. Paired <i>t</i>-tests were used to compare parameters before and after treatment and unpaired <i>t</i>-test to compare treated eyes to age-matched controls. The significance threshold was a <i>P</i> value less than .05.</p><p><strong>Results: </strong>Among 482 eyes from 241 patients, 99 (41.1%) had abnormal TBI values in ⩾1 eye. Of the cohort who completed dry eye treatment, 50 eyes from 34 patients showed improved TBI values, with a mean change of -0.2 ± 0.14 and a mean increase in pachymetry value of 7.6 ± 10.1 µm. Eyes with an increase in biomechanically corrected intraocular pressure had an increase in stiffness parameter at first applanation (SP-A1) and highest concavity (SP-HC). Comparisons between eyes after dry eye treatment with age-matched control eyes showed no differences in SP-A1 and SP-HC, but integrated inverse radius and deformation amplitude ratio were significantly stiffer in controls. Eyes after dry eye treatment had higher mean TBI values (0.2 ± 0.1) compared to age-matched controls (0.1 ± 0.1), although both were within the normal TBI cut-off value of 0.29.</p><p><strong>Conclusions: </strong>Dry eye treatment can modify the biomechanical profile in mild subclinical dry eye, rendering improvements in TBI values that may reduce the risk for subsequent refractive surgery.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"42 9","pages":"e878-e886"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148920426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}