{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T23:31:34Z","timestamp":1784590294754,"version":"3.55.0"},"reference-count":48,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T00:00:00Z","timestamp":1758672000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>To investigate the relationship between tear film thickness, corneal epithelial thickness, tear film breakup location, and dry eye in patients with high- and low-myopia undergoing femtosecond-assisted laser <jats:italic>in situ<\/jats:italic> keratomileusis (FS-LASIK).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 52 patients (52 eyes) were enrolled and divided into a low-myopia group (LMG; spherical equivalent \u2264\u22123.00 D; 26 eyes) and a high-myopia group (HMG; spherical equivalent \u2265\u22126.00 D; 26 eyes). The Ocular Surface Disease Index (OSDI), fluorescein tear film breakup time (FBUT), corneal epithelial thickness (CET), tear film thickness (TFT), and other tear film stability markers were evaluated preoperatively. Each parameter was evaluated preoperatively at 1 and 3\u202fmonths postoperatively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At 1\u202fmonth postoperatively, the HMG showed significantly higher OSDI scores and CET compared to the LMG (<jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.05). Conversely, the FBUT and TFT were significantly lower in the HMG at the same time point (<jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.05). Within a 6- to 7-mm corneal diameter, the TFT was significantly lower in the HMG than in the LMG (<jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.05). Furthermore, the change in CET from baseline at 1 and 3\u202fmonths postoperatively was significantly greater in the HMG, especially within the 5-mm corneal diameter (<jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.05). There were no significant differences in spherical equivalent (SE) or uncorrected distance visual acuity (UDVA) between 1 and 3\u202fmonths postoperatively within either group (<jats:italic>p<\/jats:italic>\u202f&amp;gt;\u202f0.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The observed alterations in tear film thickness, tear film distribution, FBUT, and tear film breakup location, affected by varying corneal stromal ablation depths, contribute to the development of dry eye disease following FS-LASIK. The extent of corneal epithelial remodeling after FS-LASIK correlates with the degree of refractive correction but not with refractive regression, and may play a role in tear film stability recovery.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2025.1650495","type":"journal-article","created":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T05:40:59Z","timestamp":1758692459000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Tear film thickness and stability following femtosecond-assisted laser in situ keratomileusis: a comparison of high- and low-myopia"],"prefix":"10.3389","volume":"12","author":[{"given":"Yan","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haibo","family":"Yan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hua","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiyang","family":"Niu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong","family":"Qi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunyan","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,9,24]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"DES109","DOI":"10.1167\/iovs.17-23538","article-title":"Dry eye after LASIK","volume":"59","author":"Toda","year":"2018","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1159\/000487951","article-title":"Plasma rich in growth factors for the treatment of dry eye after LASIK surgery","volume":"60","author":"Sanchez-Avila","year":"2018","journal-title":"Ophthalmic Res"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"675","DOI":"10.1016\/j.jcrs.2003.07.003","article-title":"Chronic dry eye and regression after laser in situ keratomileusis for myopia","volume":"30","author":"Albietz","year":"2004","journal-title":"J Cataract Refract Surg"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"396","DOI":"10.3928\/1081597X-20080401-14","article-title":"Lasik-associated dry eye and neurotrophic epitheliopathy: pathophysiology and strategies for prevention and treatment","volume":"24","author":"Ambr\u00f3sio","year":"2008","journal-title":"J Refract Surg"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1097\/IIO.0000000000000104","article-title":"Dry eye disease after refractive surgery","volume":"56","author":"Dohlman","year":"2016","journal-title":"Int Ophthalmol Clin"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"438","DOI":"10.1016\/j.ajo.2005.10.006","article-title":"The incidence and risk factors for developing dry eye after myopic LASIK","volume":"141","author":"De Paiva","year":"2006","journal-title":"Am J Ophthalmol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"368","DOI":"10.1016\/s0886-3350(99)80085-6","article-title":"Change in corneal sensitivity following laser in situ keratomileusis","volume":"25","author":"Kim","year":"1999","journal-title":"J Cataract Refract Surg"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"2624","DOI":"10.1016\/j.jcrs.2015.06.037","article-title":"Chronic dry eye in photorefractive keratectomy and laser in situ keratomileusis: manifestations, incidence, and predictive factors","volume":"41","author":"Bower","year":"2015","journal-title":"J Cataract Refract Surg"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"358","DOI":"10.3109\/08820538.2014.962663","article-title":"Dry eye after laser in-situ keratomileusis","volume":"29","author":"Raoof","year":"2014","journal-title":"Semin Ophthalmol"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1016\/j.jtos.2013.09.001","article-title":"The role of corneal innervation in LASIK-induced neuropathic dry eye","volume":"12","author":"Chao","year":"2014","journal-title":"Ocul Surf"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"10","DOI":"10.3928\/1081597X-20141218-01","article-title":"Influence of femtosecond lenticule extraction and small incision lenticule extraction on corneal nerve density and ocular surface: a 1-year prospective, confocal, microscopic study","volume":"31","author":"Ishii","year":"2015","journal-title":"J Refract Surg"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1580","DOI":"10.1016\/j.jcrs.2014.12.055","article-title":"Corneal sensitivity after small-incision lenticule extraction and laser in situ keratomileusis","volume":"41","author":"Reinstein","year":"2015","journal-title":"J Cataract Refract Surg"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1395","DOI":"10.1016\/s0161-6420(97)30125-0","article-title":"Relation between signs and symptoms of dry eye in the elderly. A population-based perspective","volume":"104","author":"Schein","year":"1997","journal-title":"Ophthalmology"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"156","DOI":"10.1167\/iovs.08-3265","article-title":"A novel method for pachymetry mapping of human precorneal tear film using Pentacam with fluorescein","volume":"51","author":"Zhuang","year":"2010","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"264","DOI":"10.1097\/ICU.0000000000000077","article-title":"Ocular surface diseases and corneal refractive surgery","volume":"25","author":"Garcia-Zalisnak","year":"2014","journal-title":"Curr Opin Ophthalmol"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1007\/s10384-018-00645-4","article-title":"Tear-film-oriented diagnosis for dry eye","volume":"63","author":"Yokoi","year":"2019","journal-title":"Jpn J Ophthalmol"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"173","DOI":"10.3928\/1081597X-20130129-08","article-title":"SD-OCT analysis of regional epithelial thickness profiles in keratoconus, postoperative corneal ectasia, and normal eyes","volume":"29","author":"Rocha","year":"2013","journal-title":"J Refract Surg"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"2277","DOI":"10.2147\/OPTH.S67902","article-title":"OCT corneal epithelial topographic asymmetry as a sensitive diagnostic tool for early and advancing keratoconus","volume":"8","author":"Kanellopoulos","year":"2014","journal-title":"Clin Ophthalmol"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"1580","DOI":"10.1167\/iovs.13-12578","article-title":"Epithelial remodeling as basis for machine-based identification of keratoconus","volume":"55","author":"Silverman","year":"2014","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"186","DOI":"10.3928\/1081597X-20140219-02","article-title":"Dry eye after small incision lenticule extraction and LASIK for myopia","volume":"30","author":"Xu","year":"2014","journal-title":"J Refract Surg"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"1050","DOI":"10.1001\/archopht.119.7.1050","article-title":"Development of the 25-item National eye Institute visual function questionnaire","volume":"119","author":"Mangione","year":"2001","journal-title":"Arch Ophthalmol"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"1930","DOI":"10.1167\/iovs.10-6997b","article-title":"The international workshop on meibomian gland dysfunction: report of the definition and classification subcommittee","volume":"52","author":"Nelson","year":"2011","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"8923","DOI":"10.1364\/OE.18.008923","article-title":"3D refraction correction and extraction of clinical parameters from spectral domain optical coherence tomography of the cornea","volume":"18","author":"Zhao","year":"2010","journal-title":"Opt Express"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"3901","DOI":"10.1167\/iovs.09-4748","article-title":"Topographic thickness of Bowman's layer determined by ultra-high resolution spectral domain-optical coherence tomography","volume":"52","author":"Tao","year":"2011","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"14880","DOI":"10.1364\/oe.17.014880","article-title":"Ultra high-speed swept source OCT imaging of the anterior segment of human eye at 200 kHz with adjustable imaging range","volume":"17","author":"Gora","year":"2009","journal-title":"Opt Express"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"680","DOI":"10.3928\/1081597X-20140903-04","article-title":"Topographic analysis of the centration of the treatment zone after SMILE for myopia and comparison to FS-LASIK: subjective versus objective alignment","volume":"30","author":"Lazaridis","year":"2014","journal-title":"J Refract Surg"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"892","DOI":"10.1097\/01.opx.0000180817.46312.0a","article-title":"Repeatability and reproducibility of central corneal thickness measurement with Pentacam, Orbscan, and ultrasound","volume":"82","author":"Lackner","year":"2005","journal-title":"Optom Vis Sci"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"937","DOI":"10.1016\/j.ophtha.2006.01.063","article-title":"Comparison of central corneal thickness measurements by rotating Scheimpflug camera, ultrasonic pachymetry, and scanning-slit corneal topography","volume":"113","author":"Amano","year":"2006","journal-title":"Ophthalmology"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"584","DOI":"10.3980\/j.issn.2222-3959.2013.05.05","article-title":"Measurement of central corneal thickness and pre-corneal tear film thickness of rabbits using the Scheimpflug system","volume":"6","author":"Dong","year":"2013","journal-title":"Int J Ophthalmol"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1016\/j.jtos.2016.09.003","article-title":"New perspectives on dry eye definition and diagnosis: a consensus report by the Asia dry eye society","volume":"15","author":"Tsubota","year":"2017","journal-title":"Ocul Surf"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1016\/s1542-0124(12)70082-4","article-title":"The epidemiology of dry eye disease: report of the epidemiology Subcommittee of the International dry eye WorkShop (2007)","volume":"5","year":"2007","journal-title":"Ocul Surf"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"1041","DOI":"10.1185\/03007995.2011.566264","article-title":"Work productivity loss in patients with dry eye disease: an online survey","volume":"27","author":"Patel","year":"2011","journal-title":"Curr Med Res Opin"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"e77797","DOI":"10.1371\/journal.pone.0077797","article-title":"Comparison of dry eye and corneal sensitivity between small incision lenticule extraction and femtosecond LASIK for myopia","volume":"8","author":"Li","year":"2013","journal-title":"PLoS One"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"277","DOI":"10.3928\/1081597X-20220127-01","article-title":"Influences of SMILE and FS-LASIK on corneal sub-basal nerves: a systematic review and network Meta-analysis","volume":"38","author":"Jiang","year":"2022","journal-title":"J Refract Surg"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"2283","DOI":"10.1007\/s10792-017-0717-x","article-title":"Dry eye evaluation and correlation analysis between tear film stability and corneal surface regularity after small incision lenticule extraction","volume":"38","author":"Zhang","year":"2018","journal-title":"Int Ophthalmol"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"150991","DOI":"10.1016\/j.bbrc.2024.150991","article-title":"Identifying the crucial binding domain of histatin-1 to recombinant TMEM97 in activating chemotactic migration in human corneal epithelial cells","volume":"739","author":"Son","year":"2024","journal-title":"Biochem Biophys Res Commun"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1097\/ICO.0000000000000999","article-title":"Dry eye after small incision lenticule extraction and femtosecond laser-assisted LASIK: Meta-analysis","volume":"36","author":"Kobashi","year":"2017","journal-title":"Cornea"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1177\/112067210701700101","article-title":"Dry eye after LASIK for myopia: incidence and risk factors","volume":"17","author":"Shoja","year":"2007","journal-title":"Eur J Ophthalmol"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"403","DOI":"10.1016\/j.jcrs.2013.07.053","article-title":"Efficacy, safety, predictability, contrast sensitivity, and aberrations after femtosecond laser lenticule extraction","volume":"40","author":"Vestergaard","year":"2014","journal-title":"J Cataract Refract Surg"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"1230","DOI":"10.1016\/s0161-6420(01)00623-6","article-title":"Effects of laser in situ keratomileusis on tear production, clearance, and the ocular surface","volume":"108","author":"Battat","year":"2001","journal-title":"Ophthalmology"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1001\/archopht.121.2.173","article-title":"Differentiation of lipid tear deficiency dry eye by kinetic analysis of tear interference images","volume":"121","author":"Goto","year":"2003","journal-title":"Arch Ophthalmol"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"810","DOI":"10.1097\/ICO.0000000000001207","article-title":"Effects of tear film lipid layer thickness and blinking pattern on tear film instability after corneal refractive surgery","volume":"36","author":"Chen","year":"2017","journal-title":"Cornea"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"304","DOI":"10.3928\/1081597X-20140416-01","article-title":"Lenticule thickness readout for small incision lenticule extraction compared to Artemis three-dimensional very high-frequency digital ultrasound stromal measurements","volume":"30","author":"Reinstein","year":"2014","journal-title":"J Refract Surg"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"OCT176-83","DOI":"10.1167\/iovs.15-18879","article-title":"Corneal epithelial Remodeling induced by small incision lenticule extraction (SMILE)","volume":"57","author":"Luft","year":"2016","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1016\/s1542-0124(12)70233-1","article-title":"The tear film and the optical quality of the eye","volume":"8","author":"Mont\u00e9s-Mic\u00f3","year":"2010","journal-title":"Ocul Surf"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1006\/jcis.1996.0595","article-title":"Deposition and thinning of the human tear film","volume":"184","author":"Wong","year":"1996","journal-title":"J Colloid Interface Sci"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"2425","DOI":"10.1016\/j.ophtha.2012.06.023","article-title":"Corneal epithelial thickness mapping by Fourier-domain optical coherence tomography in normal and keratoconic eyes","volume":"119","author":"Li","year":"2012","journal-title":"Ophthalmology"},{"key":"ref48","doi-asserted-by":"publisher","first-page":"250","DOI":"10.3928\/1081597X-20170111-01","article-title":"Comparison of corneal epithelial Remodeling after femtosecond laser-assisted LASIK and small incision lenticule extraction (SMILE)","volume":"33","author":"Ryu","year":"2017","journal-title":"J Refract Surg"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1650495\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T05:41:01Z","timestamp":1758692461000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1650495\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,24]]},"references-count":48,"alternative-id":["10.3389\/fmed.2025.1650495"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2025.1650495","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,24]]},"article-number":"1650495"}}