2026-04-14T19:37:51Zhttps://uvadoc.uva.es/oai/request

oai:uvadoc.uva.es:10324/545492022-09-26T07:46:45Zcom_10324_40357com_10324_952com_10324_894col_10324_40358

Vázquez Hernández, Amanda Martínez Plaza, Elena Fernández Martínez, Itziar Sobas Abad, Eva María González García, María Jesús Enriquez De Salamanca Aladro, Amalia Ortega, Enrique López Miguel, Alberto Calonge, Margarita 2022-08-24T09:15:19Z 2022-08-24T09:15:19Z 2022 The Ocular Surface, 2022, vol. 26, p. 63-74 1542-0124 https://uvadoc.uva.es/handle/10324/54549 10.1016/j.jtos.2022.07.010 Producción Científica Purpose: To describe the clinical characteristics of patients suffering from chronic dry eye (DE) and pain after refractive surgery (RS). Methods: Cross-sectional, observational, single-visit study. DE-, pain- and psychological-related symptoms were evaluated with specific questionnaires. DE-related tests evaluated tear osmolarity, conjunctival hyperemia, Meibomian gland dysfunction, tear stability and production, and ocular surface staining. Corneal mechanical sensitivity (Cochet-Bonnet) was measured pre/post topical anesthesia, and symptomatic variation post-anesthesia (anesthetic challenge test) was recorded. When pain was present, it was further categorized as neuropathic or nociceptive based on published criteria. Results: We recruited 104 patients (39.5 ± 9.5 years). Most, 85.6%, had corneal RS as opposed to intraocular RS. Migraines, anxiety, depression (p < 0.0001), and central sensitization syndromes (p = 0.0214) were more frequent post-RS than pre-RS. Persistent DE-symptoms, severe in 86.5% patients, developed in a range of 0–204 months post-RS. Dryness and pain were the two most frequent symptoms. The only DE-related tests showing abnormal values were tear osmolarity (315.2 ± 17.1 mOsm/L; normal ≤308) and tear break-up time (4.1 ± 2.5 s; normal >7). Corneal sensitivity was 55.4 ± 7.0 mm, and decreased (p < 0.0001) after topical anesthesia, 6.0 ± 10.4 mm. However, it remained pathologically elevated, ≥10 mm in 61 (58.7%) patients. The normal symptomatic post-anesthesia improvement was absent in 58 (55.7%) patients. Ocular pain was present in 82 (78.8%) patients, and it was categorized as neuropathic in 66 (80.5%) of them, 63.5% of the entire cohort. Conclusions: Chronic ocular pain and its neuropathic subtype were diagnosed in 78.8% and 63.5% respectively of patients seeking consultation for persistent symptomatic DE post-RS. Ministerio de Ciencia, Innovación y Universidades (grants SAF-2016-77080-P and FPU15/01443) Junta de Castilla y León - Fondo Social Europeo (grant EDU/1100/2017) application/pdf eng Elsevier info:eu-repo/semantics/openAccess http://creativecommons.org/licenses/by-nc-nd/4.0/ © 2022 The Authors Attribution-NonCommercial-NoDerivatives 4.0 Internacional Cornea Córnea Dry eye disease Ojo seco Corneal innervation Inervación corneal Refractive surgery Cirugía refractiva Phenotypic characterization of patients developing chronic dry eye and pain after refractive surgery: A cross-sectional study info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion https://www.sciencedirect.com/science/article/pii/S1542012422000659?via%3Dihub SI