{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T20:24:45Z","timestamp":1791491085127,"version":"4.3.4"},"reference-count":57,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2023,9,25]],"date-time":"2023-09-25T00:00:00Z","timestamp":1695600000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Natural Science Foundation of China","award":["81970767"],"award-info":[{"award-number":["81970767"]}]},{"name":"National Natural Science Foundation of China","award":["81970766"],"award-info":[{"award-number":["81970766"]}]},{"name":"National Natural Science Foundation of China","award":["82171102"],"award-info":[{"award-number":["82171102"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>The aim of this study was to explore the impact of dry eye disease (DED) on the uncorrected distance visual acuity (UDVA) and refractive status after small incision lenticule extraction (SMILE). This prospective cohort study enrolled 29 patients (DED group, 11 eyes; non-DED group, 18 eyes) who underwent SMILE in our center from July to September 2022. The examinations on DED, refractive status and UDVA were performed before surgery, and on day 7 and 20 after surgery. The results showed that on day 20 after SMILE, subjects in the non-DED group reported greater changes of ocular surface disease index value increase and tear-film breakup time reduction compared to baseline than those in the DED group (p &lt; 0.001 and p = 0.048, respectively). Compared to preoperative status, DED patients had greater improvements of UDVA and better optometric outcomes on day 20 after surgery than non-DED subjects (p = 0.008 and 0.026, respectively). Multiple linear regression analysis showed age, contact lens daily wearing time, and tear meniscus height before surgery were of the highest value to predict UDVA on day 20 after SMILE in contact lens wearers (p = 0.006, 0.010 and 0.043, respectively). In conclusion, preoperative tear function could affect UDVA after SMILE. The impact of DED on UDVA and refraction should be taken into consideration before surgery.<\/jats:p>","DOI":"10.3390\/jcm12196179","type":"journal-article","created":{"date-parts":[[2023,9,25]],"date-time":"2023-09-25T04:15:38Z","timestamp":1695615338000},"page":"6179","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Impact of Dry Eye Disease on the Uncorrected Distance Visual Acuity after Small Incision Lenticule Extraction"],"prefix":"10.3390","volume":"12","author":[{"given":"Yan","family":"Shen","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Eye, Ear, Nose & Throat Hospital of Fudan University, Shanghai 200031, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiajia","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Eye, Ear, Nose & Throat Hospital of Fudan University, Shanghai 200031, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xingtao","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Eye, Ear, Nose & Throat Hospital of Fudan University, Shanghai 200031, China"},{"name":"Research Center, Eye, Ear, Nose & Throat Hospital of Fudan University, Shanghai 200031, China"},{"name":"Myopia Key Laboratory of Ministry of Health, Eye, Ear, Nose & Throat Hospital of Fudan University, Shanghai 200031, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiqiang","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Eye, Ear, Nose & Throat Hospital of Fudan University, Shanghai 200031, China"},{"name":"Research Center, Eye, Ear, Nose & Throat Hospital of Fudan University, Shanghai 200031, China"},{"name":"Myopia Key Laboratory of Ministry of Health, Eye, Ear, Nose & Throat Hospital of Fudan University, Shanghai 200031, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiaxu","family":"Hong","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Eye, Ear, Nose & Throat Hospital of Fudan University, Shanghai 200031, China"},{"name":"Research Center, Eye, Ear, Nose & Throat Hospital of Fudan University, Shanghai 200031, China"},{"name":"Myopia Key Laboratory of Ministry of Health, Eye, Ear, Nose & Throat Hospital of Fudan University, Shanghai 200031, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7655-3101","authenticated-orcid":false,"given":"Qihua","family":"Le","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Eye, Ear, Nose & Throat Hospital of Fudan University, Shanghai 200031, China"},{"name":"Research Center, Eye, Ear, Nose & Throat Hospital of Fudan University, Shanghai 200031, China"},{"name":"Myopia Key Laboratory of Ministry of Health, Eye, Ear, Nose & Throat Hospital of Fudan University, Shanghai 200031, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,9,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1038\/s41572-020-00231-4","article-title":"Myopia","volume":"6","author":"Baird","year":"2020","journal-title":"Nat. Rev. Dis. Primers"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1036","DOI":"10.1016\/j.ophtha.2016.01.006","article-title":"Global Prevalence of Myopia and High Myopia and Temporal Trends from 2000 through 2050","volume":"123","author":"Holden","year":"2016","journal-title":"Ophthalmology"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/08164622.2023.2203313","article-title":"Ten-year outcomes following small incision lenticule extraction for up to -10Dioptres myopia","volume":"16","author":"Xia","year":"2023","journal-title":"Clin. Exp. Optom."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Fu, Y., Yin, Y., Wu, X., Li, Y., Xiang, A., Lu, Y., Fu, Q., Hu, T., Du, K., and Wen, D. (2021). Clinical outcomes after small-incision lenticule extraction versus femtosecond laser-assisted LASIK for high myopia: A meta-analysis. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0242059"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1007\/s40123-019-0202-x","article-title":"Comparison of Visual, Refractive and Ocular Surface Outcomes between Small Incision Lenticule Extraction and Laser-Assisted In Situ Keratomileusis for Myopia and Myopic Astigmatism","volume":"8","author":"Lau","year":"2019","journal-title":"Ophthalmol. Ther."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Wu, Y., and Huang, Z. (2021). Comparison of early visual quality in patients with moderate myopia using different optical zones in small incision lenticule extraction (SMILE). BMC Ophthalmol., 21.","DOI":"10.1186\/s12886-020-01798-y"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2507973","DOI":"10.1155\/2016\/2507973","article-title":"Comparison of the Optical Quality between Small Incision Lenticule Extraction and Femtosecond Laser LASIK","volume":"2016","author":"Jin","year":"2016","journal-title":"J. Ophthalmol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1016\/S0002-9394(01)01365-4","article-title":"Impaired functional visual acuity of dry eye patients","volume":"133","author":"Goto","year":"2002","journal-title":"Am. J. Ophthalmol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/j.jtos.2016.11.003","article-title":"Visual acuity and quality of life in dry eye disease: Proceedings of the OCEAN group meeting","volume":"15","author":"Labetoulle","year":"2017","journal-title":"Ocul. Surf."},{"key":"ref_10","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_11","doi-asserted-by":"crossref","first-page":"1057685","DOI":"10.3389\/fmed.2023.1057685","article-title":"Post-LASIK dry eye disease: A comprehensive review of management and current treatment options","volume":"10","author":"Tamimi","year":"2023","journal-title":"Front. Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"020503","DOI":"10.7189\/jogh.08.020503","article-title":"Variations of dry eye disease prevalence by age, sex and geographic characteristics in China: A systematic review and meta-analysis","volume":"8","author":"Song","year":"2018","journal-title":"J. Glob. Health"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1016\/j.jtos.2017.05.003","article-title":"TFOS DEWS II Epidemiology Report","volume":"15","author":"Stapleton","year":"2017","journal-title":"Ocul. Surf."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2085","DOI":"10.1016\/S0140-6736(18)33209-4","article-title":"Refractive surgery","volume":"393","author":"Kim","year":"2019","journal-title":"Lancet"},{"key":"ref_15","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_16","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1016\/j.jare.2020.11.001","article-title":"Comparison of tear proteomic and neuromediator profiles changes between small incision lenticule extraction (SMILE) and femtosecond laser-assisted in-situ keratomileusis (LASIK)","volume":"29","author":"Liu","year":"2021","journal-title":"J. Adv. Res."},{"key":"ref_17","doi-asserted-by":"crossref","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":"ref_18","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1136\/bjophthalmol-2013-303415","article-title":"Small incision lenticule extraction (SMILE) and femtosecond laser LASIK: Comparison of corneal wound healing and inflammation","volume":"98","author":"Dong","year":"2014","journal-title":"Br. J. Ophthalmol."},{"key":"ref_19","unstructured":"Moshirfar, M., Somani, S.N., and Patel, B.C. (2023). StatPearls, StatPearls Publishing LLC."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"454","DOI":"10.3928\/1081597X-20130617-03","article-title":"Mathematical model to compare the relative tensile strength of the cornea after PRK, LASIK, and small incision lenticule extraction","volume":"29","author":"Reinstein","year":"2013","journal-title":"J. Refract. Surg."},{"key":"ref_21","doi-asserted-by":"crossref","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":"ref_22","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1097\/ICU.0000000000000494","article-title":"A review of small incision lenticule extraction complications","volume":"29","author":"Krueger","year":"2018","journal-title":"Curr. Opin. Ophthalmol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"346","DOI":"10.3928\/1081597X-20160217-05","article-title":"Early Corneal Wound Healing and Inflammatory Responses after SMILE: Comparison of the Effects of Different Refractive Corrections and Surgical Experiences","volume":"32","author":"Liu","year":"2016","journal-title":"J. Refract. Surg."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"256","DOI":"10.3928\/1081597X-20151111-06","article-title":"Clinical Outcomes of SMILE and FS-LASIK Used to Treat Myopia: A Meta-analysis","volume":"32","author":"Zhang","year":"2016","journal-title":"J. Refract. Surg."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1097\/ICO.0000000000002240","article-title":"Comparing Dry Eye Disease after Small Incision Lenticule Extraction and Laser Subepithelial Keratomileusis","volume":"39","author":"Chung","year":"2020","journal-title":"Cornea"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"652","DOI":"10.1016\/j.jcrs.2015.02.006","article-title":"Small-incision lenticule extraction","volume":"41","author":"Moshirfar","year":"2015","journal-title":"J. Cataract. Refract. Surg."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e124","DOI":"10.1111\/aos.12204","article-title":"Comparison on the vision-related quality of life between outpatients and general population with dry eye syndrome","volume":"92","author":"Le","year":"2014","journal-title":"Acta Ophthalmol."},{"key":"ref_28","first-page":"221","article-title":"Report of the National Eye Institute\/Industry workshop on Clinical Trials in Dry Eyes","volume":"21","author":"Lemp","year":"1995","journal-title":"CLAO J."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1097\/ICO.0b013e3181acf68d","article-title":"Corneal and conjunctival sensitivity in patients with dry eye: The effect of topical cyclosporine therapy","volume":"29","author":"Toker","year":"2010","journal-title":"Cornea"},{"key":"ref_30","unstructured":"(2011). Standard for Logarithmic Visual Acuity Charts (Standard No. GB\/T 11533-2011)."},{"key":"ref_31","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_32","doi-asserted-by":"crossref","first-page":"1420","DOI":"10.1097\/OPX.0000000000000986","article-title":"Assessment of Lower Tear Meniscus","volume":"93","author":"Wei","year":"2016","journal-title":"Optom. Vis. Sci."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1266","DOI":"10.1001\/archopht.1995.01100100054027","article-title":"Ocular surface changes and discomfort in patients with meibomian gland dysfunction","volume":"113","author":"Shimazaki","year":"1995","journal-title":"Arch. Ophthalmol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"572","DOI":"10.1016\/j.ajo.2006.04.062","article-title":"Optimization of anterior eye fluorescein viewing","volume":"142","author":"Peterson","year":"2006","journal-title":"Am. J. Ophthalmol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1136\/bjo.2009.174284","article-title":"Small incision corneal refractive surgery using the small incision lenticule extraction (SMILE) procedure for the correction of myopia and myopic astigmatism: Results of a 6 month prospective study","volume":"95","author":"Sekundo","year":"2011","journal-title":"Br. J. Ophthalmol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1186\/1745-6215-13-75","article-title":"Small incision lenticule extraction (SMILE) versus laser in-situ keratomileusis (LASIK): Study protocol for a randomized, non-inferiority trial","volume":"13","author":"Ang","year":"2012","journal-title":"Trials"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1016\/j.clae.2021.02.010","article-title":"CLEAR\u2014Contact lens complications","volume":"44","author":"Stapleton","year":"2021","journal-title":"Cont. Lens Anterior Eye"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1488","DOI":"10.1136\/bjophthalmol-2021-318826","article-title":"New model to better diagnose dry eye disease integrating OCT corneal epithelial mapping","volume":"106","author":"Edorh","year":"2022","journal-title":"Br. J. Ophthalmol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"6601","DOI":"10.1167\/iovs.14-15125","article-title":"Ocular forward light scattering and corneal backward light scattering in patients with dry eye","volume":"55","author":"Koh","year":"2014","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1136\/bjo.76.3.157","article-title":"The importance of the precorneal tear film for the quality of optical imaging","volume":"76","author":"Rieger","year":"1992","journal-title":"Br. J. Ophthalmol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1016\/j.jcrs.2010.07.033","article-title":"Results of small incision lenticule extraction: All-in-one femtosecond laser refractive surgery","volume":"37","author":"Shah","year":"2011","journal-title":"J. Cataract. Refract. Surg."},{"key":"ref_42","doi-asserted-by":"crossref","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":"ref_43","doi-asserted-by":"crossref","unstructured":"Li, M., Zhao, J., Shen, Y., Li, T., He, L., Xu, H., Yu, Y., and Zhou, X. (2013). Comparison of dry eye and corneal sensitivity between small incision lenticule extraction and femtosecond LASIK for myopia. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0077797"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1016\/j.ajo.2013.12.023","article-title":"Dry eye in the beaver dam offspring study: Prevalence, risk factors, and health-related quality of life","volume":"157","author":"Paulsen","year":"2014","journal-title":"Am. J. Ophthalmol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1111\/cxo.12210","article-title":"Prevalence of and risk factors for symptomatic dry eye disease in Singapore","volume":"98","author":"Tan","year":"2015","journal-title":"Clin. Exp. Optom."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1712","DOI":"10.1136\/bjophthalmol-2014-305201","article-title":"Prevalence and risk factors of dry eye disease in a British female cohort","volume":"98","author":"Vehof","year":"2014","journal-title":"Br. J. Ophthalmol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1016\/j.ophtha.2008.10.012","article-title":"Contact lens wear is associated with decrease of meibomian glands","volume":"116","author":"Arita","year":"2009","journal-title":"Ophthalmology"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1104","DOI":"10.1016\/j.ajo.2013.01.008","article-title":"Correlation between quantitative measurements of tear film lipid layer thickness and meibomian gland loss in patients with obstructive meibomian gland dysfunction and normal controls","volume":"155","author":"Eom","year":"2013","journal-title":"Am. J. Ophthalmol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1016\/j.clae.2017.08.001","article-title":"Corneal confocal microscopy and dry eye findings in contact lens discomfort patients","volume":"41","author":"Dogan","year":"2018","journal-title":"Cont. Lens Anterior Eye"},{"key":"ref_50","first-page":"374","article-title":"Physical chemistry of the normal and disordered tear film","volume":"104","author":"Holly","year":"1985","journal-title":"Trans Ophthalmol. Soc. UK (1962)"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"112","DOI":"10.3928\/1542-8877-20060301-06","article-title":"Tear meniscus evaluation by optical coherence tomography","volume":"37","author":"Savini","year":"2006","journal-title":"Ophthalmic Surg. Lasers Imaging"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"653","DOI":"10.3109\/02713689609008906","article-title":"Tear meniscus measurement in the diagnosis of dry eye","volume":"15","author":"Mainstone","year":"1996","journal-title":"Curr. Eye Res."},{"key":"ref_53","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_54","doi-asserted-by":"crossref","first-page":"851","DOI":"10.1097\/ICO.0b013e318197ec24","article-title":"The analysis of tear meniscus in soft contact lens wearers by spectral optical coherence tomography","volume":"28","author":"Le","year":"2009","journal-title":"Cornea"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1097\/00003226-199711000-00009","article-title":"Relationship between tear-meniscus parameters and tear-film breakup","volume":"16","author":"Golding","year":"1997","journal-title":"Cornea"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1481","DOI":"10.1016\/j.jcrs.2011.03.036","article-title":"Objective optical assessment of tear-film quality dynamics in normal and mildly symptomatic dry eyes","volume":"37","author":"Benito","year":"2011","journal-title":"J. Cataract. Refract. Surg."},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Kobashi, H., Kamiya, K., Yanome, K., Igarashi, A., and Shimizu, K. (2013). Longitudinal assessment of optical quality and intraocular scattering using the double-pass instrument in normal eyes and eyes with short tear breakup time. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0082427"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/19\/6179\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:57:23Z","timestamp":1760129843000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/19\/6179"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,25]]},"references-count":57,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2023,10]]}},"alternative-id":["jcm12196179"],"URL":"https:\/\/doi.org\/10.3390\/jcm12196179","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9,25]]}}}