Features of The Ocular Surface Condition After Keratorefractive Surgery in Patients Previously Using Orthokeratological Lenses

Relevance. Myopia and myopic astigmatism remain among the most common refractive disorders in young patients. At the same time, the effect of previous orthokeratological lens wear on the ocular surface after keratorefractive surgery has not been sufficiently studied. Aim. To perform a comparative assessment of the ocular surface condition and the clinical and functional outcomes of keratorefractive surgery in patients with myopia and myopic astigmatism who had previously used orthokeratological lenses. Materials and methods. The study included 20 patients, 20 eyes, with anisometropia, mild myopia, and myopic astigmatism, with emmetropia in the fellow eye. All patients had used overnight orthokeratological lenses for up to 2 years before surgery. After standard and special ophthalmic examinations, the patients were divided into 2 groups. In group 1, LASIK was performed. In group 2, Femto-LASIK was performed. Before surgery and during the postoperative period, the Schirmer test, TFBUT, OSDI index, and axial eye length were assessed. Results. It was found that before surgery the groups were comparable in the main clinical and instrumental parameters. After LASIK, more pronounced ocular surface changes were observed, including reduced tear production, decreased tear film stability, and increased subjective complaints. After Femto-LASIK, the objective parameters remained more stable, although the OSDI index also increased. In patients who had previously used orthokeratological lenses, the axial eye length remained almost unchanged 6 months after surgery. Conclusion. Keratorefractive surgery in patients who had previously worn orthokeratological lenses is effective and predictable. Femto-LASIK has a gentler effect on the ocular surface compared with LASIK.

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