Basics of Diagnosis and Treatment of Dry Eye Syndrome During Refractive Surgery

Given the prevalence of refractive surgery in modern ophthalmological practice, when preparing a patient for this type of surgery, it is important to understand the multifactorial mechanism of the development of dry eye syndrome in this group of patients. Analysis of the literature data made it possible to identify key factors in the disruption of the tear formation process after refractive surgery, which include the intersection of the nerve endings of the cornea, which in turn reduces the frequency of blinking and the distribution of the tear film over the ocular surface, and also causes a violation regarding neurotrophic factors secreted by the nerve endings of the cornea . The presence of a postoperative inflammatory reaction, which has a specific course, manifested in a change in the biochemical properties of the tear, damage to the goblet cells of the conjunctiva during the creation of a vacuum during LASIK and SMILE, leading to a subsequent deficiency of mucin in the tear, changes in the curvature of the cornea caused by laser refractive surgery are factors influencing the development of dry eye syndrome after refractive surgery. When preparing a patient for refractive surgery, to reduce the risk of developing severe forms of dry eye syndrome, including corneal ulceration, it is necessary to take into account a history of systemic diseases and allergic reactions, especially in patients with high myopia. The influence of cosmetic procedures, such as eyelash extensions, eyelid tattooing, blepharoplasty, and the use of botulinum toxin in the periorbital area on the course of the postoperative period during refractive surgery, has been poorly studied. Research in this area opens up a new range of opportunities to reduce the incidence of dry eye syndrome in patients after refractive surgery and improve the quality of life of patients and patient satisfaction with the surgical intervention.