Choi Joon Yul, Ryu Sun Young, Yoo Tae Keun
Department of Biomedical Engineering, Yonsei University, Wonju, South Korea.
B&VIIT Eye Center, Seoul, South Korea.
BMC Ophthalmol. 2025 Mar 28;25(1):154. doi: 10.1186/s12886-025-03981-5.
Epidemiological studies on corneal refractive surgery remain limited, particularly regarding complications such as dry eye disease and refractive error regression, which impact long-term visual outcomes and patient satisfaction. This study aimed to evaluate the demographic and clinical characteristics of individuals with a history of corneal refractive surgery using data from the Korean National Health and Nutrition Examination Survey (KNHANES) 2010-2012.
This cross-sectional study included 595 participants with a self-reported history of corneal refractive surgery. Data on diagnosed dry eye disease, dry eye symptoms, and previous ocular surgeries were collected through structured questionnaires, while ophthalmologic examinations provided information on refractive errors, intraocular pressure, and other ocular conditions. Logistic regression analysis identified factors associated with dry eye disease and symptoms.
Dry eye disease and refractive error regression were frequently reported among individuals with a history of corneal refractive surgery. Among participants, 24.2% reported diagnosed dry eye disease, and 33.1% reported dry eye symptoms. Significant myopia (≤ -0.75 D) and significant astigmatism (≤ -0.75 D) were present in 49.4% and 39.7%, respectively. Using the timing of the last ophthalmologic examination as a proxy for time since surgery, results showed a progressive myopic shift in spherical refractive error over time, while the prevalence of dry eye disease and symptoms gradually declined. Female sex (OR = 1.76, 95% CI = 1.05-2.96) and prolonged sun exposure (> 5 h/day, OR = 2.47, 95% CI = 0.96-6.36) were associated with a higher likelihood of diagnosed dry eye disease, while a longer time since surgery was associated with decreased dry eye symptoms. Severe diseases such as cataracts (0.3%), glaucoma (0.5%), and surgically treated retinal disorders (0.2%) were rare.
This study provides epidemiological insights into associations between corneal refractive surgery and postoperative outcomes, highlighting dry eye disease and refractive error regression as prevalent findings, while observing that severe complications were rarely reported. Sex and sun exposure were identified as important risk factors for dry eye disease, warranting attention in preoperative counseling and postoperative care. These findings support the need for procedure-specific, longitudinal research to optimize patient outcomes and satisfaction.
关于角膜屈光手术的流行病学研究仍然有限，尤其是在干眼症和屈光不正回退等并发症方面，这些并发症会影响长期视觉效果和患者满意度。本研究旨在利用2010 - 2012年韩国国家健康与营养检查调查（KNHANES）的数据，评估有角膜屈光手术史个体的人口统计学和临床特征。
这项横断面研究纳入了595名自我报告有角膜屈光手术史的参与者。通过结构化问卷收集有关确诊的干眼症、干眼症状和既往眼部手术的数据，而眼科检查提供了有关屈光不正、眼压和其他眼部状况的信息。逻辑回归分析确定了与干眼症和症状相关的因素。
有角膜屈光手术史的个体中经常报告有干眼症和屈光不正回退。在参与者中，24.2%报告确诊有干眼症，33.1%报告有干眼症状。分别有49.4%和39.7%的人存在显著近视（≤ -0.75 D）和显著散光（≤ -0.75 D）。以上次眼科检查时间作为手术时间的替代指标，结果显示随着时间推移，球面屈光不正呈渐进性近视偏移，而干眼症和症状的患病率逐渐下降。女性（OR = 1.76，95% CI = 1.05 - 2.96）和长时间日晒（> 5小时/天，OR = 2.47，95% CI = 0.96 - 6.36）与确诊干眼症的可能性较高相关，而手术时间较长与干眼症状减少相关。白内障（0.3%）、青光眼（0.5%）和接受手术治疗的视网膜疾病（0.2%）等严重疾病较为罕见。
本研究提供了角膜屈光手术与术后结果之间关联的流行病学见解，突出了干眼症和屈光不正回退是常见的发现，同时观察到严重并发症很少被报告。性别和日晒被确定为干眼症的重要危险因素，在术前咨询和术后护理中值得关注。这些发现支持需要进行针对具体手术的纵向研究，以优化患者的治疗效果和满意度。
