Correlation Between Myopia Degree and Postoperative Dry Eye Disease in Keratorefractive Lenticule Extraction Surgery

PURPOSE: This study aimed to investigate the relationship between myopia degree and the rate of postoperative dry eye disease (DED) in participants who received keratorefractive lenticule extraction (KLEx) surgery. METHODS: A retrospective cohort study was conducted, and participants who received KLEx surgery were included. After selection, a total of 95 and 76 eyes were classified into the low myopia (LM) and high myopia (HM) groups, respectively. The main outcomes are the postoperative tear break-up time (TBUT), Schirmer test, ocular surface staining, and DED-related symptoms. The independent t-test and generalized linear model were used for the statistical analysis of the present study. RESULTS: The postoperative uncorrected distance visual acuity (UDVA) and spherical equivalent (SE) were significantly better in the LM group (all p<0.001). Regarding the postoperative DED parameters, the TBUT and Schirmer test values were significantly higher in the LM group compared to those in the HM group during the whole follow-up period (all p<0.05). The rate of superficial keratitis and multiple DED symptom were significantly higher in the HM group than the LM group one month postoperatively (both p<0.05). Advanced age correlated with poor DED sign, and female sex correlated with poor DED symptom in the LM group (both p<0.05). On the other hand, both advanced age and female sex were associated with poor DED signs and symptoms in the HM group (all p<0.05). CONCLUSION: HM may have a certain correlation with higher DED incidence and severity for participants who received KLEx surgery.