Ocular surface diseases and corneal refractive surgery.

Abstract

The purpose of this article is to provide an overview and update on recent literature regarding ocular surface disease and corneal refractive surgery. Studies involving ocular surface disease and/or keratorefractive (corneal) surgery published found on the Medline database were included in the report. Studies focused on mechanisms of refractive surgery induced dry eye disease, surgical options, including modification of technique, to prevent dry eye, and postoperative dry eye prevention and management by way of both established and novel therapies. By understanding the mechanisms of postoperative dry eye as well as patient risk factors for dry eye, patient satisfaction and surgical outcomes can be maximized. Patients identified as having an increased risk for postoperative dry eye may benefit from surgical techniques such as small-incision lenticule extraction (SMILE) and femtosecond laser-assisted in-situ keratomileusis (LASIK). Employing well known therapies such as preserved and nonpreserved artificial tears, nutritional supplements, topical cyclosporins, punctal plugs and autologus serum as well as novel therapies such as insulin-like growth factor 1, neuropeptides and acupuncture could provide improve outcomes and, if started early, could allow more patients to be candidates for corneal refractive surgery.