International Ophthalmology

, Volume 38, Issue 6, pp 2283–2288 | Cite as

Dry eye evaluation and correlation analysis between tear film stability and corneal surface regularity after small incision lenticule extraction

  • Hui Zhang
  • Yan WangEmail author
Original Paper



To investigate the dry eye after small incision lenticule extraction (SMILE) and explore the correlations between changes in the tear film stability, the tear secretion and the corneal surface regularity.


Sixty-two eyes of 22 men and 13 women who underwent SMILE were included in this study. Corneal topography was measured to assess the index of surface variance (ISV) and the index of vertical asymmetry (IVA). Dry eye tests including subjective symptom questionnaire, tear breakup time (TBUT), corneal fluorescein staining and Schirmer’s test (ST) were evaluated before and at 1 and 6 months postoperatively.


TBUT was found to be significantly decreased from 9.8 ± 3.4 s preoperatively to 7.4 ± 3.8 s at 1 month and 6.5 ± 3.6 s at 6 months (both P < 0.001). There was a significant decrease in ST at 1 month postoperatively (P = 0.012); however, ST returned to baseline by 6 months (P = 0.522). Both ISV and IVA significantly increased after the surgery (all P < 0.001). In addition, the changes in TBUT were negatively correlated with the increases in ISV and IVA (r = −0.343, P = 0.006 and r = −0.311, P = 0.014, respectively).


Patients undergoing SMILE might develop a short-TBUT type of dry eye. Corneal surface regularity indices might be helpful in the assessment of tear film stability following SMILE procedure.


Small incision lenticule extraction Dry eye Tear film stability Corneal surface regularity 



This study was supported by grants from the National Natural Science Foundation of China (Grant Nos. 81470658 and 81670884). The funding organization had no role in the design or conduct of this research.

Compliance with ethical standards

Conflict of interest

The authors have no proprietary or financial interest in any material or method mentioned.


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Copyright information

© Springer Science+Business Media B.V. 2017

Authors and Affiliations

  1. 1.Clinical College of OphthalmologyTianjin Medical UniversityTianjinChina
  2. 2.Tianjin Eye HospitalTianjinChina
  3. 3.Tianjin Key Laboratory of Ophthalmology and Visual ScienceTianjinChina
  4. 4.Tianjin Eye InstituteTianjinChina

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