{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T12:11:55Z","timestamp":1787314315454,"version":"build-2736575974"},"reference-count":47,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2022,9,27]],"date-time":"2022-09-27T00:00:00Z","timestamp":1664236800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004826","name":"Beijing Natural Science Foundation","doi-asserted-by":"publisher","award":["7202229"],"award-info":[{"award-number":["7202229"]}],"id":[{"id":"10.13039\/501100004826","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>This study aimed to evaluate the change patterns in corneal intrinsic aberrations and nerve density after cataract surgery in dry eye disease. The preoperative, 1- and 3-month postoperative dry eye-related parameters were obtained by the Oculus keratograph and the ocular surface disease index questionnaire. The corneal intrinsic aberrations were measured using the Pentacam HR system. In vivo confocal microscopy was performed to observe the vortical and peripheral corneal nerves. An artificial intelligence technique run by the deep learning model generated the corneal nerve parameters. Corneal aberrations on the anterior and total corneal surfaces were significantly increased at 1 month compared with the baseline (p &lt; 0.05) but gradually returned to the baseline by 3 months (p &gt; 0.05). However, the change in posterior corneal aberration lasted up to 3 months (p &lt; 0.05). There was a significant decrease in the corneal vortical nerve maximum length and average density after the operation (p &lt; 0.05), and this damage lasted approximately 3 months. The corneal vortical nerve maximum length and average density were negatively correlated with the anterior corneal surface aberrations before and 1 month after the operation (correlation coefficients, CC = \u22120.26, \u22120.25, \u22120.28; all p &lt; 0.05). Corneal vortex provided a unique site to observe long-term corneal nerve injury related to eye dryness. The continuous damage to the corneal vortical nerve may be due to the continuous dry eye state.<\/jats:p>","DOI":"10.3390\/jcm11195697","type":"journal-article","created":{"date-parts":[[2022,9,28]],"date-time":"2022-09-28T01:51:49Z","timestamp":1664329909000},"page":"5697","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Change Patterns in Corneal Intrinsic Aberrations and Nerve Density after Cataract Surgery in Patients with Dry Eye Disease"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2682-4625","authenticated-orcid":false,"given":"Dalan","family":"Jing","sequence":"first","affiliation":[{"name":"Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Department of Ophthalmology, Peking University Third Hospital, 49 North Garden Rd., Haidian District, Beijing 100191, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaodan","family":"Jiang","sequence":"additional","affiliation":[{"name":"Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Department of Ophthalmology, Peking University Third Hospital, 49 North Garden Rd., Haidian District, Beijing 100191, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8520-7198","authenticated-orcid":false,"given":"Xiaotong","family":"Ren","sequence":"additional","affiliation":[{"name":"Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Department of Ophthalmology, Peking University Third Hospital, 49 North Garden Rd., Haidian District, Beijing 100191, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Su","sequence":"additional","affiliation":[{"name":"Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Department of Ophthalmology, Peking University Third Hospital, 49 North Garden Rd., Haidian District, Beijing 100191, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shanshan","family":"Wei","sequence":"additional","affiliation":[{"name":"Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing 100069, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ran","family":"Hao","sequence":"additional","affiliation":[{"name":"Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing 100069, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yilin","family":"Chou","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, BenQ Medical Centre, The Affiliated BenQ Hospital of Nanjing Medical University, Nanjing 210017, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4018-9974","authenticated-orcid":false,"given":"Xuemin","family":"Li","sequence":"additional","affiliation":[{"name":"Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Department of Ophthalmology, Peking University Third Hospital, 49 North Garden Rd., Haidian District, Beijing 100191, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,9,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1309","DOI":"10.1007\/s40123-022-00513-y","article-title":"Prevalence and Characteristics of Dry Eye Disease After Cataract Surgery: A Systematic Review and Meta-Analysis","volume":"11","author":"Miura","year":"2022","journal-title":"Ophthalmol. Ther."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"S16","DOI":"10.1097\/ICO.0b013e31812f67ca","article-title":"Investigation of Dry Eye Disease and Analysis of the Pathogenic Factors in Patients after Cataract Surgery","volume":"26","author":"Li","year":"2007","journal-title":"Cornea"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1159\/000355490","article-title":"Corneal Involvement in Uneventful Cataract Surgery: An in vivo Confocal Microscopy Study","volume":"231","author":"Fogagnolo","year":"2014","journal-title":"Ophthalmologica"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1016\/j.clae.2017.11.003","article-title":"Dry eye following cataract surgery: The effect of light exposure using an in-vitro model","volume":"41","author":"Ipek","year":"2018","journal-title":"Contact Lens Anterior Eye"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Kasetsuwan, N., Satitpitakul, V., Changul, T., and Jariyakosol, S. (2013). Incidence and Pattern of Dry Eye after Cataract Surgery. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0078657"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1097\/ICO.0000000000000320","article-title":"Corneal Microstructural Changes in Nerve Fiber, Endothelial and Epithelial Density after Cataract Surgery in Patients with Diabetes Mellitus","volume":"34","author":"Misra","year":"2015","journal-title":"Cornea"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1007\/s00417-018-04225-7","article-title":"In vivo confocal microscopy morphometric analysis of corneal subbasal nerve plexus in dry eye disease using newly developed fully automated system","volume":"257","author":"Giannaccare","year":"2019","journal-title":"Graefes Arch. Clin. Exp. Ophthalmol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1111\/aos.13844","article-title":"Role of corneal nerves in ocular surface homeostasis and disease","volume":"97","author":"Labetoulle","year":"2019","journal-title":"Acta. Ophthalmol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/j.nbd.2015.12.017","article-title":"Ocular inflammation induces trigeminal pain, peripheral and central neuroinflammatory mechanisms","volume":"88","author":"Launay","year":"2016","journal-title":"Neurobiol. Dis."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"109191","DOI":"10.1016\/j.exer.2022.109191","article-title":"Corneal nerves and their role in dry eye pathophysiology","volume":"222","author":"Vereertbrugghen","year":"2022","journal-title":"Exp. Eye Res."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"3409","DOI":"10.1167\/iovs.08-1951","article-title":"In Vivo Laser Scanning Confocal Microscopy Confirms that the Human Corneal Sub-basal Nerve Plexus Is a Highly Dynamic Structure","volume":"49","author":"Patel","year":"2008","journal-title":"Investig. Opthalmol. Vis. Sci."},{"key":"ref_12","first-page":"461","article-title":"Comparison of consistency of corneal epithelial basal plexus in vortex area and central area by laser scanning confocal microscope","volume":"40","author":"Yu","year":"2020","journal-title":"Recent Adv. Ophthalmol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"4312","DOI":"10.1167\/iovs.04-0693","article-title":"Corneal Aberrations before and after Small-Incision Cataract Surgery","volume":"45","author":"Guirao","year":"2004","journal-title":"Investig. Opthalmol. Vis. Sci."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"700","DOI":"10.1016\/j.ophtha.2014.10.002","article-title":"Quality of vision after bilateral multifocal intraocular lens implantation: A randomized trial\u2014AT LISA 809 M versus AcrySof ReSTOR SN6AD1","volume":"122","author":"Maurino","year":"2015","journal-title":"Ophthalmology"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1631","DOI":"10.1016\/j.jcrs.2007.06.019","article-title":"Role of the tear film in the optical quality of the human eye","volume":"33","year":"2007","journal-title":"J. Cataract Refract. Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"DES36","DOI":"10.1167\/iovs.17-23500","article-title":"Irregular Astigmatism and Higher-Order Aberrations in Eyes with Dry Eye Disease","volume":"59","author":"Koh","year":"2018","journal-title":"Investig. Opthalmol. Vis. Sci."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1016\/j.jtos.2017.05.001","article-title":"TFOS DEWS II Diagnostic Methodology report","volume":"15","author":"Wolffsohn","year":"2017","journal-title":"Ocul. Surf."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1001\/archopht.118.5.615","article-title":"Reliability and Validity of the Ocular Surface Disease Index","volume":"118","author":"Schiffman","year":"2000","journal-title":"Arch. Ophthalmol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1016\/j.jcrs.2008.11.038","article-title":"Catquest-9SF patient outcomes questionnaire: Nine-item short-form Rasch-scaled revision of the Catquest questionnaire","volume":"35","author":"Pesudovs","year":"2009","journal-title":"J. Cataract Refract. Surg."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1097\/ICO.0000000000002804","article-title":"Correlation of Measures from the OCULUS Keratograph and Clinical Assessments of Dry Eye Disease in the Dry Eye Assessment and Management Study","volume":"41","author":"Sutphin","year":"2021","journal-title":"Cornea"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e1307","DOI":"10.1111\/aos.14833","article-title":"Comparison of intense pulsed light and near-infrared light in the treatment of dry eye disease: A prospective randomized study","volume":"99","author":"Ren","year":"2021","journal-title":"Acta. Ophthalmol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1167\/tvst.9.2.32","article-title":"A Deep Learning Model for Automated Sub-Basal Corneal Nerve Segmentation and Evaluation Using In Vivo Confocal Microscopy","volume":"9","author":"Wei","year":"2020","journal-title":"Transl. Vis. Sci. Technol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1016\/j.ophtha.2014.10.004","article-title":"Dry eye disease after refractive surgery: Comparative outcomes of small incision lenticule extraction versus LASIK","volume":"122","author":"Denoyer","year":"2015","journal-title":"Ophthalmology"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"DES109","DOI":"10.1167\/iovs.17-23538","article-title":"Dry Eye After LASIK","volume":"59","author":"Toda","year":"2018","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1535","DOI":"10.1097\/ICO.0000000000001741","article-title":"Epidemiology of Persistent Postsurgical Pain Manifesting as Dry Eye-Like Symptoms After Cataract Surgery","volume":"37","author":"Sajnani","year":"2018","journal-title":"Cornea"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1016\/j.jtos.2017.05.008","article-title":"TFOS DEWS II Definition and Classification Report","volume":"15","author":"Craig","year":"2017","journal-title":"Ocul. Surf."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"734","DOI":"10.1097\/ICO.0000000000001572","article-title":"Perioperative Ocular Parameters Associated with Persistent Dry Eye Symptoms After Cataract Surgery","volume":"37","author":"Choi","year":"2018","journal-title":"Cornea"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Park, Y., Bin Hwang, H., and Kim, H.S. (2016). Observation of Influence of Cataract Surgery on the Ocular Surface. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0152460"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Cetinkaya, S., Mestan, E., Acir, N.O., Cetinkaya, Y.F., Dadaci, Z., and Yener, H.I. (2015). The course of dry eye after phacoemulsification surgery. BMC Ophthalmol., 15.","DOI":"10.1186\/s12886-015-0058-3"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1144","DOI":"10.1016\/j.ajo.2014.02.036","article-title":"Evaluation of Dry Eye and Meibomian Gland Dysfunction after Cataract Surgery","volume":"157","author":"Han","year":"2014","journal-title":"Am. J. Ophthalmol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1016\/j.clae.2012.04.002","article-title":"Clinical evaluation of the Oculus Keratograph","volume":"35","author":"Best","year":"2012","journal-title":"Contact Lens Anterior Eye"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1097\/ICL.0000000000000596","article-title":"Repeatability of Noninvasive Keratograph 5 M Measurements Associated with Contact Lens Wear","volume":"45","year":"2019","journal-title":"Eye Contact Lens"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1803","DOI":"10.1167\/iovs.11-8706","article-title":"Mapping the Corneal Sub-Basal Nerve Plexus in Orthokeratology Lens Wear Using in vivo Laser Scanning Confocal Microscopy","volume":"53","author":"Lum","year":"2012","journal-title":"Investig. Opthalmol. Vis. Sci."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1097\/ICO.0b013e318193e0e3","article-title":"Corneal Sensitivity and Slit Scanning In Vivo Confocal Microscopy of the Subbasal Nerve Plexus of the Normal Central and Peripheral Human Cornea","volume":"28","author":"Patel","year":"2009","journal-title":"Cornea"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1097\/ICL.0000000000000042","article-title":"The Core Mechanism of Dry Eye Disease Is Inflammation","volume":"40","author":"Wei","year":"2014","journal-title":"Eye Contact Lens"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1615","DOI":"10.1136\/bjophthalmol-2018-312333","article-title":"Effects of tear film dynamics on quality of vision","volume":"102","author":"Koh","year":"2018","journal-title":"Br. J. Ophthalmol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"108851","DOI":"10.1016\/j.exer.2021.108851","article-title":"Change patterns in the corneal sub-basal nerve and corneal aberrations in patients with dry eye disease: An artificial intelligence analysis","volume":"215","author":"Jing","year":"2021","journal-title":"Exp. Eye Res."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Zhang, X., M, V.J., Qu, Y., He, X., Ou, S., Bu, J., Jia, C., Wang, J., Wu, H., and Liu, Z. (2017). Dry Eye Management: Targeting the Ocular Surface Microenvironment. Int. J. Mol. Sci., 18.","DOI":"10.3390\/ijms18071398"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1135","DOI":"10.1016\/j.jcrs.2019.02.038","article-title":"Changes in total, anterior, and posterior corneal surface higher-order aberrations after 1.8 mm incision and 2.8 mm incision cataract surgery","volume":"45","author":"He","year":"2019","journal-title":"J. Cataract Refract. Surg."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1244","DOI":"10.1097\/OPX.0000000000000362","article-title":"Changes of Corneal Higher-Order Aberrations after Cataract Surgery","volume":"91","author":"Ye","year":"2014","journal-title":"Optom. Vis. Sci."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"588","DOI":"10.1016\/j.jcrs.2010.12.037","article-title":"Anatomy and physiology of the cornea","volume":"37","author":"DelMonte","year":"2011","journal-title":"J. Cataract Refract. Surg."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"660","DOI":"10.1016\/j.jcrs.2011.10.030","article-title":"Healing changes in clear corneal cataract incisions evaluated using Fourier-domain optical coherence tomography","volume":"38","author":"Wang","year":"2012","journal-title":"J. Cataract Refract. Surg."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1603","DOI":"10.1016\/j.jcrs.2014.01.041","article-title":"Optical coherence tomography\u2013derived corneal thickness asymmetry indices: Clinical reference study of normal eyes","volume":"40","author":"Kanellopoulos","year":"2014","journal-title":"J. Cataract Refract. Surg."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/j.preteyeres.2015.07.002","article-title":"Progress in corneal wound healing","volume":"49","author":"Ljubimov","year":"2015","journal-title":"Prog. Retin. Eye Res."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1016\/j.jcrs.2015.09.029","article-title":"Near-term analysis of corneal epithelial thickness after cataract surgery and its correlation with epithelial cell changes and visual acuity","volume":"42","author":"Zheng","year":"2016","journal-title":"J. Cataract Refract. Surg."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1253","DOI":"10.1097\/ICO.0000000000002060","article-title":"Corneal Subbasal Nerve Analysis Using In Vivo Confocal Microscopy in Patients with Dry Eye: Analysis and Clinical Correlations","volume":"38","author":"Liu","year":"2019","journal-title":"Cornea"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1097\/ICO.0000000000001057","article-title":"Patients with Dry Eye Disease and Low Subbasal Nerve Density Are at High Risk for Accelerated Corneal Endothelial Cell Loss","volume":"36","author":"Kheirkhah","year":"2017","journal-title":"Cornea"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/19\/5697\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:40:06Z","timestamp":1760143206000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/19\/5697"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,27]]},"references-count":47,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2022,10]]}},"alternative-id":["jcm11195697"],"URL":"https:\/\/doi.org\/10.3390\/jcm11195697","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,27]]}}}