Objective . To compare the corneal asphericity and higher‐order aberrations (HOAs) of femtosecond laser‐assisted in situ keratomileusis (FS‐LASIK) with Smart Pulse Technology (SPT) assisted transepithelial photorefractive keratectomy (Trans‐PRK) for myopia and myopic astigmatism correction. Methods . This prospective study analyzed 88 eyes of 44 patients treated with FS‐LASIK and 64 eyes of 32 patients treated with Trans‐PRK. All eyes had low to moderate myopia with or without astigmatism (spherical equivalent (SE) <−6.00 diopters). The uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), SE, asphericity ( Q value) of the anterior corneal surface, index of surface variance (ISV), corneal higher‐order aberrations (HOAs), vertical coma (Z ₃ ⁻¹ ), horizontal coma (Z ₃ ¹ ), and spherical aberration ( Z ₄ ⁰ ) over a 6 mm diameter central corneal zone diameter were evaluated preoperatively and 1, 3, and 6 months postoperatively. Results . At 6 months, the UDVA and SE were −0.14 ± 0.06 and 0.33 ± 0.33D in FS‐LASIK and −0.15 ± 0.06 and 0.35 ± 0.37D in Trans‐PRK. There was no difference between the two groups in the postoperative UDVA and SE ( P > 0.05). After FS‐LASIK and Trans‐PRK, the Q values in the 6, 7, 8, and 9 mm zones and ISV of the anterior corneal surface significantly increased ( P < 0.001). At 1, 3, and 6 months after surgery, corneal HOA, Z ₃ ^-1 , Z ₃ ¹ , and Z ₄ ⁰ in both groups were significantly increased compared with those before surgery, with statistically significant differences ( P < 0.001). At 1, 3, and 6 months after surgery, the Z ₃ ⁻¹ of the Trans‐PRK group was significantly lower than that of the FS‐LASIK group ( P < 0.001). ΔHOA and ΔZ ₄ ⁰ were dramatically correlated with the ΔQ value for both FS‐LASIK and Trans‐PRK procedures. The ΔQ was significantly correlated with the preoperative SE, AD, and AD/CCT after both two procedures (all P < 0.001). Conclusions . Both FS‐LASIK and Trans‐PRK caused the anterior corneal surface to become flatter, and the morphology of the corneal surface was irregular. Corneal HOAs were significantly increased after the two procedures. Trans‐PRK using SPT introduced less corneal vertical coma than FS‐LASIK. Corneal asphericity changes contributed to the corneal aberrations changes following FS‐LASIK and Trans‐PRK.

This study aimed to investigate the association between dry eye disease (DED) and DED-related anxiety and depression tendencies, as well as the risk factors for anxiety and depression in patients with DED of different age groups. This was a cross-sectional study involving 160 patients with DED and 80 healthy individuals aged 20–65 years. All participants completed the investigation of the demographic characteristics, the Hospital Anxiety Depression Scale (HADS), the Ocular Surface Disease Index (OSDI) questionnaire, the Standard Patient Evaluation of Eye Dryness (SPEED) questionnaire, and underwent objective clinical eye examinations. In patients aged 20–40 years, anxiety and depression scores were correlated with OSDI, sleep disorders, and Best Corrected Visual Acuity (BCVA). In patients with DED aged 41−65 years, anxiety scores were correlated with sleep disorders, the level of DED impact on life and work, and the severity of DED. Depression scores were correlated with sleep disorders and the severity of DED. The results indicated that the tendency for anxiety and depression was closely associated with DED and sleep disorders. Moreover, the factors affecting anxiety and depression in patients varied with age.

Background: This study aimed to explore the associations between Demodex infestation and the ocular surface characteristics of meibomian gland dysfunction (MGD) in different age groups, to further understand the effect of Demodex on MGD. Methods: A total of 202 consecutive MGD patients aged 18 to 70 years were randomly recruited. All patients were divided into two groups based on their age: young patients (18–40 years) and elderly patients (41–70 years). The main observations were the different relationship between Demodex infestation and ocular surface and meibomian gland (MG) parameters in two age groups. We also compared ocular surface and MG parameters between the young and the elderly groups. Demodex infestation was diagnosed based on expert consensus in China. Results: Our results indicated significant differences among young Demodex-positive, suspicious-positive, and negative patients in MG dropout (P = 0.000), plugging of MG orifices (P = 0.000), lid margin abnormality (P = 0.000), and meibum quality (P = 0.000). In elderly patients, there were significant differences among the Demodex-positive, suspicious-positive, and negative groups in terms of ocular surface disease index (OSDI) (P = 0.037), fluorescein tear film break-up time (FBUT) (P = 0.002), corneal fluorescein staining (CFS) (P = 0.036), MG dropout (P = 0.000), plugging of MG orifices (P = 0.008), lid margin abnormality (P = 0.000), and MG expression (P = 0.037). The mean number of mites in elderly Demodex-positive patients (10.64 ± 7.50) was greater than that of in young patients (7.60 ± 4.71) (P = 0.014). MG dropout (P = 0.000), plugging of MG orifices (P = 0.006), lid margin abnormality (P = 0.000), MG expression(P = 0.001), and meibum quality (P = 0.032) were more severe in elderly Demodex-positive patients. Additionally, FBUT (P = 0.005) was lower and tear film lipid layer thickness (LLT) (P = 0.001) was higher in the elderly. Conclusion: The effect of Demodex infestation on the ocular surface and MG parameters of MGD was different in patients of different ages. It is necessary to pay more attention to the diagnosis and treatment of Demodex infestation in MGD.

AIM: To compare the changes in the objective visual quality of patients with low and moderate myopia postoperatively after transepithelial photorefractive keratectomy using the smart pulse technology (SMART) and femtosecond laser in situ keratomileusis (FS-LASIK). METHODS: Corneal higher-order aberrations (HOAs), horizontal coma, vertical coma and spherical aberration were measured using Pentacam, and cutoff for modulation transfer function (MTF cutoff), objective scatter index (OSI) and Strehl ratio (SR) was measured using an optical quality analysis system (OQAS-II), before and after operation at 1, 3, and 6mo, and data were analyzed by repeated measurement two-way analysis of variance. RESULTS: The difference in uncorrected distance visual acuity between SMART and FS-LASIK was statistically significant only 1wk postoperatively. Approximately 86.36% and 80.69% of patients with spherical equivalent (SE) in ±0.50 D were observed in the SMART and FS-LASIK groups, respectively. No significant difference was observed in SE between the two groups (P=0.509). The HOAs increased postoperatively compared with those before surgery in both groups (P0.05). Corneal vertical coma and Δcorneal vertical coma in the FS-LASIK group were higher than those in the SMART group (P<0.05). The OSI of both groups at 1mo after surgery was higher than that before surgery (P0.05). CONCLUSION: The HOAs increase and visual quality is delayed in both groups postoperatively, and the long-term objective visual quality after SMART is slightly better than that after FS-LASIK.

We examined the effects of climatic factors and Demodex infestations on meibomian gland dysfunction (MGD)-associated dry eye disease (DED) in a cross-sectional study. This study included 123 patients from Tianjin and Chengdu regions, and climate factors and the Air Quality Index (AQI) were recorded for one year. Ocular surface parameters and Demodex infestations were evaluated using various tests. Significant differences in all climatic factors and AQI were observed between Tianjin and Chengdu (P < 0.01), and ocular surface parameters also differed significantly between the two regions (P < 0.05). Temperature, relative humidity, and precipitation positively correlated with tear break-up time (BUT), meibum gland expressibility, and lid margin irregularity but negatively correlated with lissamine green staining scores (P < 0.05). Wind speed and atmospheric pressure positively correlated with corneal fluorescein staining and lissamine green staining but negatively correlated with BUT and lid margin irregularity (P < 0.05). AQI positively correlated with DED symptoms and corneal findings but negatively correlated with tear film stability and meibomian gland characteristics (P < 0.05). Demodex infestation was only positively correlated with meibum quality scores (P < 0.05). Our findings suggest that geographic climates influence ocular surface characteristics in MGD-associated DED, with daily precipitation potentially playing a significant role, and Demodex infestation contributes to meibum gland degeneration.

Purpose: To observe the changes in corneal epithelial thickness after FS-LASIK and Trans-PRK surgery and to investigate the impact of corneal epithelial remodeling on Q-value and HOA. Methods: In this prospective cohort study, 50 patients (100 eyes) underwent FS-LASIK and 45 patients (90 eyes) underwent Trans-PRK. Anterior segment OCT was used to measure the corneal epithelial thickness in different corneal zones (central zone: 0–2 mm; paracentral zone: 2–5 mm; and mid-peripheral zone: 5–6 mm) preoperatively and postoperatively at 1 week, 1 month, 3 months, and 6 months. The correlation between △CET in the superior, nasal, inferior, and temporal region at 6 months postoperatively and △Q and △HOA was analyzed. Results: At 6 months postoperatively, the epithelial thickness increased in the central, paracentral, and mid-peripheral zones in FS-LASIK and Trans-PRK. Central epithelial thickness and different regions of the paracentral zone and mid-peripheral exhibited significant thickening ( P < 0.001). In the para-central zone and mid-peripheral zone, the △CET in different regions after LASIK and Trans-PRK was positively correlated with △Q ( P < 0.05) and △HOA ( P < 0.05). Conclusion: After FS-LASIK and Trans-PRK, significant epithelial thickening was observed. Epithelial changes in different regions lead to different Q-values in different regions and have different effects on HOA. This has a certain guiding significance for the design of refractive surgery, and minimizing the increase of Q-value may improve the postoperative visual quality.